orthopedics notes

Apr 16th, 2015
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Dr Lutomia Mark LumbasiStructureofbone Living tissueCollagen type 1- fibre forming(resists distraction andbending not compression)Hydroxy-appatite deposit non organicTo stiffen the collagen helps withstand compression Ca10(PO4)6(OH)2Structure of bone With age, relative mineral content increases andwater reducesArticular cartilage Collagen type 2- resist compression non fibre forming Interface is proteoglycans, many types, Main one is AggrecanArticular cartilage Aggrecan: core protein with CHO chainsCHO are keratan and chondroitin sulphateThe PG interact with hyaluronan which captures manyof them to make one big complexArticular cartilage Proteoglycans- highly charged- bind collagen andattract water. Water accounts for 70% of wet cartilage mass Ageing- keratan increases, chondroitin reduces andaggrecan dehydrates.Articular cartilage Other smaller PGs egDermatan sulphate- bind growth factorsExtracellular non collagenous proteins eg anchorin,fibronectin, thrombomodulin, thrombospondin andcartilage oligomeric matrix protein.Gross structure of bone Cortex shell encloses plates of trabecularbone(spongy/cancellous) Cortex thick at diaphysis-resist bending Cortex thin at metaphysis, spine- compression Wolfs law-every change in the functional loading of bone isfollowed by certain changes in its internal architecture and externalconformation.Lamella bone and woven bone Norma

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