What is the leading form of disability in ths US?
Arthritis
What is the most common type of arthritis?
OA?
True or false: OA tends to be bilateral? Why is this a problem?
True; Problem bc it could possible be a systemic manifestation
Why has there been an incr in the prevalence of OA?
Peeps are living longer & are obese
Who is arthritis more common in & why?
Women over 50 bc after menopause, estrogen decr so there’s less Ca2+
What causes OA?
Genetics, Prior Injuries, & Poor Biomechanics
Where do OA-related degenerative changes occur?
Articular Cartilage, Synovium, & Subchondral Bone
Non-Modifiable Risk Factors for OA
- Age
- Gender
- Race
- Genetics
- Nutritional Status
- Congenital/Devo Defects
- Trauma
Modifiable Risk Factors for OA
- Obesity
- Managing repitive stress
- Weakness
- Altered jt biomechanics
- Risk reduction for trauma, sport
- Estrogen deficiency
- C-reactive protein
What is the 1st-line tx for OA?
Acetaminophen
When is OA-related disability the worst?
When pt is older, inactive, & has comorbidites
Risk Factors for Hip OA
- > 60y/o
- Family Hx
- Hip Devo Disorders
- Trauma
Signs & Sx’s of Hip OA
- Decr/Painful Hip ROM
- Groin, thigh, or butt pain referred into the knee that worsens w/activity/prolonged inactivity, & is worse in the AM
- Pain last >30min
- Stiffness
- Fxnl Limitations
- Gait Deviations
Clinical Prediction Rule for Hip OA
1) Squatting aggravates sx’s
2) Lateral hip pain w/active hip flexion
3) Lateral hip/groin pain w/adduction
4) Pain w/active hip extension
5) Passive hip IR <25
Tx for hip OA
- Pt ed
- Gait training w/AD
- Activity modification
- Strengthening, esp abductors
- Manual Therapy
- Endurance Exercise
- Assess work & hobbies
- Psychological status
Avascular Necrosis
Death of bone (femoral head) due to poor blood supply, leading to micro-fx’s & eventual collapse of the structure
Who does AVN effect more?
Males age 40-65
What are typical causes of AVN?
Trauma, Alcoholism, & Long-term corticosteroid use
Sx’s of AVN
Mild-severe hip/groin/thigh pain w/WB, progressing to all the time
How is AVN dx’ed?
X-ray, Bone Scan, & MRI
AVN tx
- Relative rest
- Stim for bony regrowth
- Core Decompression Surgery or THA
What is core decompression surgery done for & what does it involve?
- Done for AVN
- Necrotic bone is removed to incr space & stim bony regrowth/revascularization
- Not effective for advanced AVN
Types of Pelvic Fx’s
- Avulsion
- Traumatic
- Stress
- Osteoporotic
What are injuries associated w/traumatic pelvic fx?
- Excessive Bleeding
- Neurological Injury
- Urogenital Injury
- DVT
-
1) ST & Bone Healing63
-
8) Pediatric Orthopedics57
-
8) Elbow & Hands65
-
7) Shoulder63
-
9) Osteoporosis54
-
10) Imaging22
-
10) Multiple Sclerosis74
-
2) Foot & Ankle Pathologies31
-
3) OA25
-
3) Hip & Knee Pathologies137
-
4) Hip & Knee Replacement16
-
4) Spine & Neck26
-
11) Stroke72
-
12) Spinal Cord Injury84
-
13) GBS36
-
13) TBI69
-
14) Degenerative Medicine70
-
15) Regenerative Medicine31
-
15) Shoulder Fx's10
-
Running Injuries from Kines27
