4: Cartilage injuries of the knee Flashcards Preview

MSK Week 4 2017/18 > 4: Cartilage injuries of the knee > Flashcards

Flashcards in 4: Cartilage injuries of the knee Deck (19)
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1
Q

Which type of cartilage covers synovial joints?

A

Hyaline cartilage

2
Q

What is the purpose of hyaline cartilage in synovial joints?

A

Distributes load

Decreases joint friction

3
Q

What are the three components of hyaline cartilage, apart from chondrocytes?

A

Water

Collagen

Proteoglycans

4
Q

How do chondrocytes gain nutrition?

A

Synovial fluid

Bone marrow

5
Q

What are the two broad categories of cartilage injury?

A

Traumatic

Atraumatic (OA, inflammatory arthritis)

6
Q

What material replaces hyaline cartilage when it is damaged?

A

Fibrocartilage

more friction, less wear resistant, overall a bit crap

7
Q

What is osteochondritis dissecans?

A

Cracks in cartilage and subchondral bone

May splinter off into joint cavity, produce locking of the knee joint

8
Q

Why does cartilage and bone crack in osteochondritis dissecans?

A

Loss of blood supply

9
Q

What can be carried out to treat osteochondritis dissecans?

A

Cartilage regeneration techniques

10
Q

Describe a common cartilage regeneration technique.

A

Drilling holes in cartilage

bleeding, blood clots form, stem cells differentiate into chondrocytes and lay down fibrocartilage, “repairing” defect

11
Q

How long does the fibrocartilage produced by a cartilage regeneration technique stick around?

A

About 5 years

Not long, but can be helpful for patient

12
Q

What “wear and tear” disease of joints involves an imbalance between cartilage breakdown and repair and leads to joint deformity?

A

Osteoarthritis

13
Q

How is early osteoarthritis treated?

A

Non-pharmacological: weight loss, walking stick, exercise, activity modification

Pharma: basic analgesia

14
Q

When would steroid injections be used for OA?

A

Rarely in the case of an acute flare-up of disease

15
Q

What surgery can be carried out to reduce the OA impact of pathological genu varum / valgum?

A

Osteotomy

literally breaking the bone and adjusting the joint alignment

16
Q

What procedure is the last option, only offered to elderly patients with end stage arthritis?

A

Knee replacement

17
Q

Although most patients report a good QOL after total knee replacement, what complaint may 20% of patients have afterwards?

A

Ongoing pain

18
Q

How long to TKRs last on average?

A

15-20 years

19
Q

What are risks of TKR surgery which patients must be made aware of?

A

Deep infection - 1%

Pain, stiffness

DVT / PE

Death