Download Orthopedic principles--a resident's guide by David Ip PDF

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 Read more...

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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.

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