8.17 OA

Question 1

factors that predispose to OA

Answer 1

• injuries (single and multiple)
• repetitive actions
• surgeries
• sports
• obesity
• age

Question 2

predisposing factors for OA: repetitive actions

Answer 2

typically associated with force

Question 3

predisposing factors for OA: age

Answer 3

historically associated with older people, but now getting younger

Question 4

What is the hip capsular pattern?

Answer 4

hip flexion » abd » IR

Question 5

What can cause locking/pseudolocking with OA?

Answer 5

• loose bodies

- bone on bone (osteophytes)

Question 6

hip OA: location of pain

Answer 6

deep in groin

Question 7

hip OA: When does it hurt more?

Answer 7

• with activity

- after periods of rest

Question 8

hip OA: does rest ease pain?

Answer 8

yes

Question 9

Conducting the exam when you suspect hip OA

Answer 9

• may be better to use distraction to find out if it eases rather than aggravating tests (scour, etc.)
• look at step length and stance time

Question 10

with hip OA, step length will be

Answer 10

shorter on unaffected side

Question 11

with hip OA, stance time will be

Answer 11

shorter on affected side

Question 12

education for hip OA pts

Answer 12

• activity modification (sleeping positions)
• HEP (strengthening around the joint)
• using distraction to decrease pain

Question 13

What should a strength program for a hip OA pt be focused on?

Answer 13

Greater focus on endurance than large strength gains

Strengthen everything around the joint

Question 14

How often will you need to see a hip OA pt?

Answer 14

• Won’t see them very often

- Trying to work on functional movements and delay hip replacement

Question 15

Where does OA start?

Answer 15

inflammation in bone due to microtrauma

Question 16

Is OA usually symmetrical?

Answer 16

no

Question 17

Where does OA generally occur the most?

Answer 17

WB joints

• hips
• knees
• spine

Question 18

In addition to osteophytes, what can also form in the bone with OA?

Answer 18

subchondral cysts

Question 19

What can osteophyte formation cause? (s/s)

Answer 19

• pain
• bone mice
• limited ROM (anatomical or self-selected)
• loss of alignment

Question 20

What happens to ligaments with OA?

Answer 20

Get both laxity and tightening that potentiates varus/valgus deformities

Question 21

What happens in the synovium/capsule with OA?

Answer 21

Capsule is stretched, but is not heavily involved

Question 22

Generally, this happens to the cartilage with OA

Answer 22

• Thickens at first, then softens

- Thins » lost

Question 23

Muscle involvement with OA

Answer 23

• Guarding for pain
• Initial placement into varus/valgus
• Compensation

Question 24

What is the problem with thickening of the cartilage with OA?

Answer 24

• Thickening creates additional compression that exacerbates the OA
• Get compensatory changes to offload the joint

Question 25

Mental changes with OA pts

Answer 25

Depression: prolonged pain makes them sad and grumpy High energy expenditure

Question 26

Heberdeen nodules are located here

Answer 26

DIP joints

Question 27

Bouchard nodules are located here

Answer 27

PIP joints