Knee Arthroplasty: A Case Study
Pt has end stage osteoarthritis. OA occurs when the cartilage or cushion between joints breaks down leading to pain, stiffness and swelling. Pt was admitted into facility following a cemented cruciate-retaining right total knee arthroplasty due to OA. OA can be caused by several factors. Pt states that she worked in restaurants her whole working life, and attributes damage to standing on hard surface flooring. Pt has had inflammation in both knees for several years and could no longer walk on right leg without assistive devices and frequent breaks due to pain and the knee giving out on her. As OA progresses, surface areas of the articular cartilage flake off and deeper layers develop longitudinal fissures (fibrillation). The cartilage becomes
thin and may be absent over some areas, leaving the underlying bone (subchondral bone) unprotected. The subchondral bone becomes dense and hard. Articular cartilage is lost through a cascade of cytokine and anabolic growth factor pathways. Enzymatic processes assist in breaking the macromolecules of proteoglycans, glycosaminoglycan’s, and collagen into large, diffusible fragments. The loss of proteoglycans from articular cartilage is the hallmark of the OA process.
thin and may be absent over some areas, leaving the underlying bone (subchondral bone) unprotected. The subchondral bone becomes dense and hard. Articular cartilage is lost through a cascade of cytokine and anabolic growth factor pathways. Enzymatic processes assist in breaking the macromolecules of proteoglycans, glycosaminoglycan’s, and collagen into large, diffusible fragments. The loss of proteoglycans from articular cartilage is the hallmark of the OA process.