By David Ip
The scope of orthopedic wisdom has accelerated to any such measure that it has turn into more and more tough to keep up a primary snatch of the mandatory wisdom base. this is often compounded by the point constraints on grownup studying, with the scholar or practitioner confronted with ever-increasing calls for on their time. this article is a far wanted source of orthopedic wisdom, so one can turn out beneficial not just to those in education but additionally to these confronted via the ever-increasing calls for of certification and recertification examinations. good illustrated and arranged into 8 chapters extending fro. Read more...
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Additional info for Orthopedic principles--a resident's guide
Disrupted matrix macromo- lecular structure ± results in more water, less proteoglycan aggregates n Stage 2: chondrocytes detect the tissue damage and release mediators n n n n that stimulate a cellular response ± both anabolic/catabolic activities increased, and more cells (explains why in some cases the process may improve/abort/revert). Histology: `clones of proliferating cells surrounded by newly synthesised matrix molecules is a hallmark' Stage 3: progression of cartilage loss and abated anabolic response Subchondral area: increased density, cyst forms, cyst cavities with myxoid/fibrous/cartilage tissues, appearance of regenerating cartilage within and on subchondral bone surface.
3 Lavage and Debridement n Pain relief in OA cases from removal of loose intra-articular debris, inflammation, mediators, enzymes. 5 Microfracture Technique n Advocated by Richard Steadman of Colorado n Procedure: Steadman believes that removal of the calcified layer is very important and damage to the subchondral bone should be avoided n Arthroscopic awl used to make many holes (microfractures) in the exposed subchondral bone; 3±4 mm apart; depth of about 4 mm n Goal: a blood clot rich in pluripotential marrow elements to form and stabilise while it covers the lesion.
G. 8 Appendix 1 Role of Vitamin D in Calcium and Phosphate Metabolism n UV light converts dietary pro-vitamin D2 and D3 to cholecalciferol n Then undergoes 25- and 1-hydroxylation at the liver and kidney re- n n n n spectively (in cases with high calcium, mainly 24,25-dihydroxy vitamin D will be made in the kidney) Acts on targets by diffusion through cytoplasmic membrane; bound to cellular protein and transported to the nucleus In bone, stimulates both osteoblasts and osteoclasts, increases mineralisation and resorption and increases collagen production Kidney: like PTH, vitamin D increases calcium absorption.