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A 32-year-old male sustains the injury shown in Figure A. He undergoes surgical fixation with subsequent removal of hardware. He does well for 10 years and then presents to your office with increasing left knee stiffness and pain for the last 6 months. He reports no constitutional symptoms or recent trauma. His physical exam is notable for well-healed incisions, a mild effusion, no ligamentous instability, and 5-100 degrees of range of motion. An XR is obtained and shown in Figure B. Which of the following correctly lists the cytokines produced following the initial injury that may contribute to the findings shown in Figure B and the patient's current symptoms?
IL-1ß, TNF-a, nitric oxide, matrix metalloproteinases, aggrecans, damage-associated molecular patterns
FGF4, BMP6, nitric oxide, matrix metalloproteinases, basic FGF, VEGF
IL-8, BMP2, TNF-a, damage-associated molecular patterns, aggrecans, BMP5
VEGF, M-CSF, IL-1ß, BMP2, BMP6, nitric oxide
BMP5, basic FGF, nitric oxide, aggrecans, TNF-a, IL-1ß
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A 32-year-old runner sustains a trimalleolar left ankle fracture. She undergoes open reduction and internal fixation and is kept non-weightbearing after surgery. At 2 months, what changes will occur in the articular cartilage of both her knees as a result of her current weightbearing regimen?
Cartilage thickening in the left (ipsilateral) knee and no change in cartilage thickness in the right (contralateral) knee
Cartilage thinning in both knees
Cartilage thinning in the left (ipsilateral) knee and no change in cartilage thickness in the right (contralateral) knee
Cartilage thinning in the left (ipsilateral) knee and increased cartilage thickness in the right (contralateral) knee
Increased cartilage thickness in both knees
What proteinaceous compound binds to hyaluronic acid to function as an effective boundary molecular layer in articular cartilage?
Which of the following best describes the appearance of chondrocytes and orientation of collagen fibrils in the superficial zone of articular cartilage?
Round chondrocytes oriented parallel with the tidemark and collagen fibrils oriented perpendicular to the tidemark
Round chondrocytes oriented parallel with the tidemark and collagen fibrils oriented parallel to the tidemark
Flattened chondrocytes oriented parallel with the tidemark and collagen fibrils oriented perpendicular to the tidemark
Flattened chondrocytes oriented perpendicular with the tidemark and collagen fibrils oriented perpendicular to the tidemark
Flattened chondrocytes oriented parallel with the tidemark and collagen fibrils oriented parallel to the tidemark
Which of the following contributes most to the ability of hyaline cartilage to attract water?
Figure A displays a schematic of the zones of articular hyaline cartilage. Which of the following zones has been shown to contain articular cartilage progenitor cells?
What part of the articular cartilage has the highest concentration of proteoglycans and the lowest concentration of water?
Which of the following substances makes up the majority by weight of the extracellular matrix for articular cartilage?
Collagen type II
Which of the following features of metal-on-metal total hip arthroplasty does not allow for improved fluid film lubrication between the components?
Larger femoral head
Slight clearance of fit between the acetabular cup and the femoral head
Minimal surface roughness of the femoral head
Complete congruence of fit between the acetabular cup and the femoral head
Minimal surface roughness of the acetabular cup
Which of the following statements regarding articular cartilage is TRUE?
Cartilage is an isotropic material
Most of the water in articular cartilage exists in the deep layer next to the calcified cartilage
Cartilage only heals if the injury does not pass through the tidemark
Calcified cartilage is the only place that type IV collagen is found
Cartilage exhibits stress shielding of the solid matrix components
A 28-year-old marathon runner has a knee MRI done to evaluate medial sided knee pain. No meniscus tear is identified, but the articular cartilage of the femoral condyles is noted to be twice as thick as normal values. What is the most likely cause of this finding?
Synovial cytokine sensitization due to excess running
Extra-articular hydrostatic pressure changes
Chondrocyte modulation via mechanotransduction
Which of the following biochemical changes are common to both aging cartilage and osteoarthritic (OA) cartilage?
Increased water content
Decreased collagen content and decreased modulus of elasticity
Decreased proteoglycan content
Increased chondroitin sulfate concentration
Decreased keratin sulfate concentration