Abrasion arthroplasty: a surgical technique, performed arthroscopically, to remove the hard, polished bone tissue from the surface of the joint. The scraping action causes a healing response in the bone, with new blood vessels entering the area, bringing stem cells, and causing the formation of fibrocartilage.
Arthroplasty: a surgical joint repair procedure
Arthroscopic: see: arthroscopy
Arthroscopy: a minimally invasive technique which means that the recovery period after surgery is much reduced, and you may be able to go home the same day as the operation. Two 4-5mm incisions (or “portals”) are made in the joint, with care being taken to protect nearby nerves or blood vessels: through one portal a miniature fiber-optic TV camera is passed into the joint which shows an image on a video-screen, whilst the required surgical instruments are fed through the other. This surgical method is used for checking the condition of soft tissues such as cartilage etc. and repairing any damage.
Articular cartilage: hard, slippery material that enables bones in the joints to move against each other smoothly. Has virtually no blood supply, so cannot be naturally replaced by the body.
Bone marrow: a soft, jelly-like tissue that is found on the inside of certain bones (pelvis, sternum, ribs, femur, humerus etc.), which is rich in undifferentiated “stem” cells. These stem cells create cells for a variety of tissues, in particular blood cells.
Bone marrow stimulation procedures: these are surgical techniques, performed in arthroscopy, on the outer layers of subchondral bone which have been laid bare after the cartilage has been lost or damaged. They encourage blood to flow to the treated area, bringing bone marrow cells which are able to generate fibrocartilage. The fibrocartilage provides a new protective covering for the bone. The most common procedures are chondroabrasion and microfracture.
Bone spur: lump or outgrowth of the bone. Formed when the body tries to repair itself by producing more bone – usually in response to rubbing, pressure or stress over a period of time.
Bursa: flat, fluid-filled membrane that acts as a shock absorber and enables smooth movement of the tendons and ligaments over the bones of a joint. They can become inflamed (a condition called "bursitis") and the amount of liquid increases substantially, stretching the membrane sac.
Bursitis: see: bursa
Cemented prosthesis: this is a prosthesis which is fixed in place with a special type of acrylic glue, called bone cement. Sometimes antibiotics are added to this glue to prevent any possible infection.
Claw toe: all three bones in the toe should form a straight line. With claw toe, the first bone in the toe is raised, the second two bones are pointing downwards.
Connective tissue: this is the most common tissue in the body. Connects and supports the various parts of the body. It repairs tissues by forming scars. It is produced by specialised cells called fibroblasts, and it is made up of fibre (mainly collagen) embedded in an amorphous substance.
CT scan: CT stands for computerised tomography. It is an x-ray that takes three-dimensional pictures, that allows the surgeon to see the bones without shadows from other bones as on an x-ray.
Debridement: arthroscopic debridement is carried out on more minor damaged areas and is aimed at removing debris and smoothing surfaces to prevent or delay further progression of the problem. It is a surgical “clean-up” of a diseased or damaged area.
Extension: the movement of straightening a limb. The bones of the joint move from a bent position (flexed) until they are in a straight line. The opposite of flexion.
Fibrocartilage: a tough, dense fibrous material that the body produces naturally to heal damage to the articular cartilage, and to protect the exposed bone surface. However, it is not a perfect replacement for the very strong, smooth articular cartilage that previously covered the bone.
Flexion: the movement of bending a limb. The bones of a joint move from being in a straight line, to a bent position. The opposite of extension.
Graft: bone or tissue is taken from another part of the body and attached to another piece of bone. A hole may be drilled or a section cut off the bone to enable the donor tissue to fuse with the bone.
Hammer toe: all three bones in the toe should form a straight line. With hammer toe, the first bone of the toe is slightly raised, the second bone is tilted downwards and the bone at the tip is almost flat.
Hemarthrosis: the presence of blood in a joint. The most common cause is a trauma that has damaged one or more of the structures in the joint (e.g. tendons, ligaments, cartilage etc.).
Hyaluronic acid injection: this is the injection of a lubricating substance that is present naturally in the synovial fluid of your joints. It is a useful treatment in various joint problems – in particular osteoarthritis.
Hyperbaric oxygen therapy: is the medical use of oxygen at a higher than atmospheric pressure. It was originally developed as a treatment for diving disorders, such as decompression sickness. The patient sits in a pressurized chamber, and the increased pressure improves blood supply to the tissues and raises the levels of oxygen, helping keep oxygen-starved tissues alive. At the end of the treatment, the pressure is gradually reduced back to atmospheric levels.
Instability: this is often the result of a serious sprain that has caused one or more of the ligaments to break. The bones of the joint have too much freedom of movement, and this causes pain and swelling (particularly after exercise) and the joint feels unstable. If there is joint instability, the joint is liable to sprain again, damaging the articular cartilage and thus leading to the premature onset of osteoarthritis.
Joint: the point where the ends of two or more bones meet. The bones are held together by bands of fibrous tissue called ligaments. A fibrous capsule (joint capsule) encloses the joint, and is filled with synovial liquid. The lining of the capsule is called the synovium, or synovial membrane.
Joint effusion: the presence of an excessive quantity of synovial fluid in a joint. It is almost always caused by synovitis.
Joint replacement: a surgical operation that is performed on a damaged joint, in order to restore correct functioning. The ends of the bones are replaced with artificial components which substitute the damaged tissues, and restore the original shape of the bones before they were damaged.
Lateral: this means on the outer side of the body, e.g. lateral meniscus: the meniscus on the outside of the knee. The opposite of medial.
Ligaments: bands of fibrous tissues that connect bones to other bones. They are formed of multiple strands of collagen fibres bound together, like the strands of a rope.
Magnetotherapy: this therapy influences cell behavior by inducing electrical changes around and within the cell. Improved blood supply increases the oxygen pressure, activating and regenerating cells. Improved calcium transport increases absorption of calcium in bones and improves the quality of cartilage in joints, decreasing pain.
Mallet toe: all three bones in the toe should form a straight line. With mallet toe, the first two bones of the toe are in line, but slightly raised. The bone at the tip is pointing downwards.
Medial: this means closer to the middle of the body, e.g. medial meniscus: the meniscus on the inside of the knee
Meniscus: a disc or half-moon of softer cartilage that acts as a cushion or shock absorber in the joints. It has a limited blood supply so it cannot be naturally replaced by the body.
Microfracture: a technique for stimulating the bone marrow. Small holes are made in the surface of the subchondral bone which has been laid bare by damage or loss of articular cartilage. Blood flows to the site of these holes, bringing regenerative bone marrow cells.
MRI: or magnetic resonance imaging, is a method used by doctors to scan the human body to obtain diagnostic information. MRI uses magnetic fields, radio waves and sophisticated computers to generate images of the inner parts of the body in a non-invasive manner. It is particularly useful for showing the condition of soft tissues.
Open surgery: the procedure is carried out while looking straight at the area under surgery, without using cameras and monitors. Scarring is usually greater and healing takes longer than with an arthroscopy.
Orthotics: special, custom-made inserts for shoes, designed to help the movement of foot function correctly. Used for many foot, knee and ankle-related problems, including ankle instability.
Osteoarthritis: there are about 100 different types of arthritis, but the most common is degenerative or osteoarthritis. It usually occurs in people over 50, often as a result of previous injury to a joint, or simply the wearing away of cartilage. The disease causes bones to become misshapen, which affects the movement of the joint, and usually also results in soft tissue damage.
Osteoporosis: a disease of the bone where the density of the bone reduces. Bones with this condition are more likely to fracture. In most cases it is linked with ageing, particularly in women after menopause, although it can be caused by hormone problems, bad diet or lack of exercise.
Osteotomy: a surgical procedure during which a bone is cut, in order to correct its shape or position.
Paresthesia: a change in sensitivity (pins and needles, tingling, a feeling of heat or cold) caused by an irritation of the nerve fibres.
Pronation: a term that applies to the hand or foot, when they are rotated externally out of normal alignment. In the foot, pronation means that the inside edge of the foot is lower than the outside edge (the soles face “outwards”, away from each other). The opposite of supination.
Shock wave therapy: a non-invasive treatment commonly used in orthopaedics to treat both soft tissues (tendons, ligaments and muscles) and some bone diseases. It uses an "acoustic" wave stimulation to produce an anti-inflammatory effect, and also it encourages the formation of new blood vessels, promoting tissue healing.
Sprain: the over-stretching of ligaments, usually as a result of a violent twisting action on a joint. Depending on the severity of the sprain, the ligament may stretch, tear, or even break completely. If the ligaments do not heal perfectly, the joint may be unstable.
Subchondral bone: the layer of bone immediately underneath the articular cartilage, which is laid bare when the cartilage is damaged or degenerates.
Supination: a term that applies to the hand or foot, when they are rotated internally out of normal alignment. In the foot, supination means that the outside edge of the foot is lower than the inside edge (the soles face “inwards”, towards each other). The opposite of pronation.
Suture anchor: fixation device for fixing tendons and ligaments to bone. It consists of a metal or biodegradable screw, which is fixed into the bone, and has a hole at the top, called an eyelet. The suture is threaded through the tendon/ligament and the eyelet – thus fixing the tissue to the bone.
Synovial cyst: a lump that contains synovial fluid and forms in or near a joint, or on the sheath that coats a tendon (tendinous cyst).
Synovial fluid: a pale yellow, viscous liquid that is present in the joints and in the sheath of tendons. It lubricates the tissues and helps movement. Normally it is produced in small quantities by the synovium, but the quantity increases if the synovium becomes inflamed (synovitis).
Synovitis: inflammation of the synovial membrane. It can be caused by traumas, rheumatic or metabolic conditions (such as gout) or tumours. The main symptoms are pain and swelling.
Synovium: also called the synovial membrane. A tissue that coats the inside of moving joints. It is made up of various types of cell; some that specialise in producing synovial liquid, and others that remove debris that forms in the joint.
Tendons: bands of fibrous tissues that connect muscles to bones. They are formed of multiple strands of collagen fibres bound together, like the strands of a rope.
Uncemented prosthesis: with this type of prosthesis, bone cement is not used to hold the components in place. Instead, the prosthesis is covered with a mesh that acts as a scaffold, onto which new bone cells attach and grow, thus binding the prosthesis to the bone.
Valgus: a limb, or part of a limb, that has moved laterally (bent outwards) out of normal alignment. The opposite of varus.
Varus: a limb, or part of a limb, that has moved medially (bent inwards) out of normal alignment. The opposite of valgus.