Glossary of Terms

Glossary of Acronyms and Terms Used on SurfaceHippy

A

Abduction

Movement of an extremity away from the body.

Abscess

A pus-filled area that affects skin or organs.

Acetabulum

The receptacle for the head of the femur; formed by the ilium, ischium, and pubis.

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Adduction

Movement of an extremity toward the body.

Agonists

Muscles that produce body movement in the same direction.

Allograft

Biologic tissue from a cadaver that is used to surgically replace damaged tissue

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Anaphylaxis

A violent hypersensitivity reaction, resulting in shock.

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Anterior compartment syndrome

Increased soft-tissue pressure in the anterior compartment of the lower leg, resulting in pain, decreased sensation, and muscle paralysis

Anterior surface

Surface at the front of the body, facing the examiner.  With hip resurfacing there are two different types of anterior approace, anterolateral which has the incision on the side of thehip but the surgeon dislocates the hip from the front and cuts through the gluteus muscles and the Direct anterior approach where the incision is through the front of the hip and spares most muscles

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Anteroposterior (AP) view

Anterior-posterior view in which the x-ray tube is in front and the film cassette is in back. The x-ray beam passes from front to back.

ASR

Articular Surface Replacement, brand name of DePuy’s metal-on-metal hip resurfacing device.

Avascular necrosis

A condition in which cells die as a result of inadequate blood supply; see also osteonecrosis

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B

BHR

Birmingham Hip Resurfacing

Bacteria

One of five types of microorganisms that commonly causes disease, characterized by absence of a nucleus and endoplasmic reticulum. Bacteria are classified according to their shape and are designated as gram positive or gram negative.

Bacteriocidal

Classification of antibiotic in which bacteria are destroyed.

Bacteriostatic

Classification of antibiotic in which bacteria are not killed, but are prevented from reproducing.

Bilateral

Both sides, bilateral hip surgery means both the left and right side are done, sometimes simultaneously. 

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Biomechanics

The study of external and internal forces applied to the body and their relationship to stability and motion.

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Bone remodeling

A process that couples bone resorption by osteoclasts with deposition of osteoblasts (new bone cells)

Bone scan

A study used to identify lesions in bone such as fracture, infections, or tumor. A radioisotope is injected into a vein and allowed to circulate through the body. The distribution of radioactivity in the skeleton is measured by a special camera that can detect the emission of gamma rays. Lesions in bone with increased metabolic activity (eg, fracture, tumor, or infection) will show increased uptake of the radioisotope and appear as a dark area in the bone. Also called bone scintigraphy

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Bursa

A sac formed by two layers of synovial tissue that is located where there is friction between tendon and bone or skin and bone

Bursitis

Inflammation of a bursa

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C

C/C

Ceramic on Ceramic articulation

C+

Conserve Plus hip resurfacing device by Wright Medical

C2K

Cormet 2000, aka Corin, marketed by Stryker

Cyst

A hole that develops in bone due to synovial fluid pressure when cartilage is lacking; a solitary fluid-filled cyst (cavity) in a bone

Custom Device

FDA classification that allows a specific surgeon to implant a device in patients on a limited basis.

Capillaries

Small, thin-walled blood vessels that have close contact with individual cells of the body.

Capsule

A collagenous structure that surrounds a joint like a sleeve. The capsule allows motion of joints and protects the articular cartilage. The capsule, along with ligaments, tendons, and bony structure, provides stability of the joint

Cartilage

A cellular tissue that, in the adult, is specific to joints, but in children forms a template for bone formation and growth. Hyaline cartilage is a low-friction cellular tissue that coats joint surfaces. Fibrocartilage is tough with high collagen content, such as found in the meniscus of the knee, or the anulus fibrosus portion of the intervertebral disk

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Closed fracture

A fracture that does not disrupt the integrity of the surrounding skin

Closed reduction

A procedure to restore normal alignment of a fractured bone or dislocated joint in which the fractured bones are simply manipulated and no incision is needed

Comminuted fracture

A fracture with more than two fragments

Compound fracture

Any fracture in which the overlying skin has been penetrated

Computed tomography (CT, CAT scan)

A radiographic modality that allows cross-sectional imaging from a series of x-ray beams. The x-ray tube is rotated 360° around the patient, and the computer converts these images into a two-dimensional axial image. CT is capable of imaging bone in three planes: coronal, sagittal, and oblique. This modality is particularly useful in evaluating fractures and bone tumors

the diameter of the spinal canal.

Connective tissue

Tissue that connects and supports the structures of the body

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COX-2

Cyclooxygenase-2 enzyme; an enzyme that is thought to be present in the body only when induced in response to injury and is responsible for the formation of prostaglandins that mediate pain and inflammation

Coxa magna

A deformity of the hip in which the ball of the hip joint is enlarged. May be secondary to Legg-Perthes disease or arthritis.

Coxa valgus

A valgus or abduction deformity of the hip. The neck/shaft angle in increased.

Cyst

A hole that develops in bone due to synovial fluid pressure when cartilage is lacking; a solitary fluid-filled cyst (cavity) in a bone

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D

Deep venous thrombosis (DVT)

Venous clot formation caused by immobilization, hypercoagulation, obstructed venous flow, or endothelial injury, among others

Deformation

The amount of lengthening or shortening in a structure divided by the structure's original length.

Degenerative joint disease (DJD)

Deterioration of the articular cartilage that lines a joint, which results in narrowing of the joint space and pain; osteoarthritis

Delayed-onset muscle soreness (DOMS)

Muscle pain or discomfort that follows unaccustomed vigorous exercise and persists for several days despite the cessation of activity.

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Delayed union

A delay in normal fracture healing; not necessarily a pathologic process

Diastasis

Separation of the distal tibia and fibula.

Dislocation

Complete disruption in the normal relationship of two bones forming a joint (ie, no contact of the articular surfaces). The direction of the dislocation is described by the position of the distal bone (eg, with an anterior dislocation of the shoulder, the humerus is displaced anterior to the scapula).

Displaced fracture

A fracture that produces deformity of the limb

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Distal

Location in an extremity nearer the free end; location on the trunk farther from the midline or from the point of reference

Dorsal

Toward the posterior surface of the body

Dual-energy x-ray absorptiometry (DEXA or DXA)

A diagnostic imaging technology that uses two different x-ray voltages to assess bone density

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Dynamic stabilization

The use of muscle strength and muscle coordination during performance of activities; used in rehabilitation.

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Dynamic strength

The magnitude of isotonic or isokinetic contraction

Dysplasia

A broad term that describes a condition affecting growth or development in which the primary defect is intrinsic to bone or cartilage

Dystrophy

A condition resulting from defective or faulty nutrition, broadly construed to include nourishment of tissue by all essential substances, including those normally manufactured by the body itself

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E

Effusion

The presence of fluid within a joint

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Effusion

Intra-articular swelling.

Electrical muscle stimulation (EMS)

Treatment in which the biphasic current delivers stimulation to muscles in a variety of ways, including pulse, surged, or tetanizing contractions

Enchondral bone healing

Process in which capillaries grow among mesenchymal cells, forming a fibrovascular tissue known as callus that bridges the gap between bone ends

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Enchondral ossification

The process of long bone formation where the cartilage model is replaced by bone.

Endochondral ossification

The formation of bone within a cartilage model

Epidural hematoma

A blood clot located outside the dura mater.

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Epiphysis

A part of a long bone developed from a center of ossification distinct from that of the shaft and separated at first from the latter by a layer of cartilage; the rounded end of a long bone at the joint.

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Epitenon

A glistening, synovial-like membrane that envelops the tendon surface.

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Exostosis

A spur or bony overgrowth.

Extension

Movement of an extremity posterior to or behind the body.

Extensor

A muscle, the contraction of which causes movement at a joint with the consequence that the limb or body assumes a more straight line, or so that the distance between the parts proximal and distal to the joint is increased or extended; the antagonist of a flexor

Extensor mechanism

Complex interaction of muscles, ligaments, and tendons that stabilizes the patellofemoral joint and acts to extend the knee

External fixation

Stabilization of a fracture or unstable joint by inserting pins into bone proximal and distal to the injury that are then attached to an external frame.

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External rotation

Lateral rotation of an extremity relative to the body.

F

FAI

Femoral Acetabular Impingement

Fascia

Sheet or band of tough fibrous connective tissue; lies deep under the skin and forms an outer layer for the muscles

Fascicles

Bundles of fibers within muscle fibers.

Fatigue fracture

Microfracture that occurs when the bone is subjected to frequent, repeated stresses, such as in running or marching long distances, and the rate of bone breakdown exceeds the rate of bone repair.

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FDA

Food & Drug Administration (U.S. Regulatory commission)

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Femoral condyles

Two surfaces at the distal end of the femur that articulate with the superior surfaces of the tibia

Femoral head

Proximal end of the femur, articulating with the acetabulum

Femoral neck

The bone connecting the head and the shaft of the femur; fractures frequently occur in this area

Femoral nerve palsy

Pain and weakness in the femoral nerve distribution as the result of a stretch or trauma to the nerve.

Fibrocartilage

A mesh of collagen fibers, proteoglycans, and glycoproteins, interspersed with fibrochondrocytes.

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Fibrochondrocytes

Cells that are able to synthesize fibrous extracellular proteins and have the rounded appearance of chondrocytes

Flexibility

The capacity of a muscle to lengthen or stretch

Flexion

Movement of an extremity anterior to or in front of the body.

Flexor

A muscle the action of which is to flex or bend a joint

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Fluoroscopy

A special type of radiograph that shows continuous motion of the structure, such as wrist motion

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Fracture

A disruption in the integrity of a bone

Fracture-dislocation

A fracture of bone associated with a dislocation of its adjacent joint.

Fracture reduction

The realignment of fracture fragments to restore normal anatomy of the bone

Fusion (arthrodesis)

The joining of two bones into a single unit, thereby obliterating motion between the two. May be congenital, traumatic, or surgical.

G

Galeazzi fracture

Glucosamine sulfate

A fundamental component in the synthesis of both hyaluronic acid and chondroitin that is thought to promote cartilage repair and synthesis; the oral form is taken as a dietary supplement to treat arthritis

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Greater trochanter

Broad, flat process at the upper end of the lateral surface of the femur to which several muscles are attached

H

Hallux valgus

Deformity at the first metatarsophalangeal joint where the proximal phalanx deviates laterally; also known as a bunion.

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Hamstrings

Three muscles in the posterior region of the buttock and thigh that provide an extension force at the hip and a flexion force at the knee.

Head

The upper or proximal portion of a structure; the head of a bone is the rounded end that allows joint rotation

Hemarthrosis

A collection of blood within a joint.

Hematoma

A collection of blood resulting from injury

Hemi -

Literally Greek for half, Hemi Hip Resurfacing is just a resurfacing of the femur, with no acetabluar component

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Heterotopic ossification

The formation of bone in any nonosseous tissue; often occurs following trauma

Hippy

Nickname for someone that has some form of a hip implant

HMO

Health Maintenance Organization, a “managed care” health insurance system in the U.S. where referrals are screened by a PCP, and specialists are limitied to those in the HMO network of providers

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Hydroxyapatite

The mineral component of bone matrix that is deposited into the organic framework to make the bone hard and strong.

Hypermobility

An increase in normal motion.

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Hysteresis

The amount of relaxation, or variation in the load-deformation relationship, that takes place within a single cycle of loading and unloading in soft tissue.

I

ICES

Ice, compression, elevation, and splinting

IDE

Investigational Device Exemption, FDA classification that allows the implanting of a device during a clinical trial

Iliotibial band (ITB) syndrome

An overuse injury where repetitive flexion and extension causes inflammation of the iliotibial band when it rubs over the lateral femoral condyle.

Impingement syndrome

Shoulder pain caused by tendinosis of the rotator cuff tendon or irritation of the subacromial bursa. See also Rotator cuff impingement, external, and Rotator cuff impingement, internal

Inflammation

A localized tissue response initiated by the injury or destruction of vascularized tissues. Inflammation Heat, redness, swelling, and pain that accompany musculoskeletal injuries; occurs when tissue is crushed, stretched, or torn

Instability

Looseness, unsteadiness, or an inability to withstand normal physiologic loading without mechanical deformation.

Ins

Insurance

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Internal fixation

Surgical insertion of a device that stops motion across a fracture or joint to encourage bony healing or fusion

Internal rotation

Medial rotation of an extremity relative to the body.

Bone formation characterized by the aggregation of undifferentiated mesenchymal cells, which differentiate into osteoblasts

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J

Joint

The junction between the ends of two adjacent bones.

Joint capsule

A thin, but strong structure in the elbow that plays a role in ligamentous restraint.

Joint manipulation

Skilled, passive movement of a joint (or spinal segment) either within or beyond its active range of motion; also known as joint mobilization.

Joint mobilization

Passive movement techniques used to treat joint dysfunctions such as stiffness, reversible joint hypomobility, and pain.

Joint play

Capsular laxity that allows movement at the joint that may be demonstrated passively, but cannot be actively performed by the patient; used in joint mobilization.

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Jones fracture

Stress fracture of the proximal shaft of the fifth metatarsal; a fracture that frequently heals with difficulty

Juvenile rheumatoid arthritis

A chronic inflammatory disease in children that is characterized by pain, swelling, and tenderness in one or more joints and may result in impaired growth and development

JRI

Joint Replacement Institute in Los Angeles

L

Lateral

Lying away from the midline

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Lateral articular surface

A bony process on each end of the clavicle.

Lateral condyle

Forms the lateral border of the upper surface of a joint

Lateral view

A view that passes from side to side at 90° to an AP or PA view

Lavage

The irrigation or thorough washing of an infected joint with high-volume saline solution

LBHR or LTHR

Left Birmingham Hip Resurfacing device or Left Total Hip Replacement

Legg-Calvé-Perthes disease

Osteonecrosis of the proximal femoral epiphysis that most commonly affects boys aged 3 to 8 years.

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Ligament

A collagenous tissue that connects two bones to stabilize a joint

Limb salvage

Surgical removal of a tumor without amputation of the affected extremity

of the tarsometatarsal joint

Load

Any force or combination of forces applied to the outside of a structure.

M

Magnetic resonance imaging (MRI)

An imaging modality that depends on the movement of protons in water molecules. When subjected to a magnetic field, protons that are normally randomly aligned become aligned. Radiowaves directed at the tissue to be studied are used to change the alignment of these photons. When the radiowaves are turned off, the protons emit a signal that is detected and processed by a computer into an image. In the musculoskeletal system, MRI is useful in diagnosing soft-tissue injuries, tumors, stress fracture, and infection.

Medial

Lying toward the midline

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Medial articular surface

A bony process on each end of the clavicle.

Medial collateral ligament injuries

An acute knee injury that is the result of a blow to the lateral side of the knee when the foot is planted; commonly seen in football players and snow skiers.

Medial condyle

Forms the medial border of the upper surface of a joint

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Midline

Imaginary straight vertical line drawn from midforehead through the nose and the umbilicus to the floor

MoM or M/M

Metal on Metal articulation

Metal/poly

Metal to polyethylene articulation

N

Navicular bone

Bone with which the head of the talus articulates on the medial side of the foot; also a bone in the wrist that articulates with the trapezium, trapezoid, and other carpal bones

Neuralgia

Pain along the course of a nerve

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Neurapraxia

A temporary loss of neural function

Neuritis

Inflammation or irritation of a nerve

Neuroma

A tumor composed of nerve cells

Neuropathic arthritis

The chronic, progressive destruction of a joint that is caused by the loss of sensation from an underlying neurologic dysfunction; also known as Charcot arthropathy

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NHS

National Health System in England

Nocioceptive

Pain-sensing

Nondisplaced fracture

Fracture in which there is no deformity of the limb

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Nonsteroidal anti-inflammatory drugs (NSAIDs)

A broad group of chemically heterogeneous drugs that share important clinical and tissue effects: all have some analgesic, antipyretic, and anti-inflammatory activity. Includes aspirin, ibuprofen, indomethacin, naproxen, and others.

O

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Open reduction

An open surgical procedure in which normal or near-normal relationships are restored to a fractured bone or dislocated joint

OS

Orthopedic Surgeon

Osteolysis

Death or resorption of bone cells causing softening of bone

Osteoarthritis (OA)

A deterioration of the weightbearing surface; distinguished by destruction of the hyaline cartilage and narrowing at the joint space.

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Osteoblasts

Cells that form new bone.

Osteocytes

The cells of established bone

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Osteolysis

Dissolution of bone, particularly as resulting from excessive resorption

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Osteomyelitis

Infection of bone, either bacterial or mycotic

Osteonecrosis

The death of bone, often as a result of obstruction of its blood supply

Osteopenia

Bone fragility as the result of a low-calcium diet.

Osteoperiostitis

A painful inflammation of the periosteum or lining of bone.

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Osteophytes

Overgrowth of bone, common in osteoarthritis and spinal stenosis

Osteoporosis

Deterioration of bone tissue resulting in an increased risk of fracture as the result of a low-calcium diet.

Osteosynthesis

The process of bony union, as in fracture healing. It is a biologic welding process that is sometimes facilitated with grafts of bone from the iliac crest and insertion of fixation devices

Osteotomy

Literally, cutting a bone. Used to describe surgical procedures in which bone is cut and realigned

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P

Pain

A sensory and emotional reaction precipitated by actual or anticipated injury; results from damage to tissue or nerves and is made worse by pressure or inflammation.

PE

Polyethylene an alternative bearing surface for some Total Hip Replacement implants

Pelvis

A bony ring, consisting of the sacrum, coccyx, and innominate bones, that connects the trunk to the lower extremities, supports the abdominal contents, and allows passage of the excretory canals

Portable transcutaneous electrical nerve stimulation (TENS) unit

A portable therapeutic modality that uses electrical stimulation to attempt to modulate pain, strengthen muscles, and enhance soft-tissue healing

Posttraumatic arthritis

A form of secondary osteoarthritis caused by a loss of joint congruence and normal joint biomechanics

Proprioception

A sense or perception, usually at a subconscious level, of the movements and position of the body and especially its limbs, independent of vision; this sense is gained primarily from input from sensory nerve terminals in muscles and tendons (muscle spindles) and the fibrous capsule of joints combined with input from the vestibular apparatus

Proximal

describing structures that are closer to the trunk

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Pseudarthrosis

A false joint produced when a fracture or arthrodesis fails to heal

Pseudofractures

Lines of radiolucency that represent stress fractures with unmineralized osteoid

PT

Physical Therapy

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R

Range of motion (ROM)

The amount of movement available at a joint

Referred pain

Pain that is perceived in a different location from the location of pathology.

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Reflex

Fairly fixed pattern of response or behavior similar for any given stimulus; does not involve a conscious action

Regeneration

The production of tissue that is structurally and functionally identical to tissue damaged by injury.

Rehabilitation

Restoration, following disease, illness, or injury, of the ability to function in a normal or near-normal manner

Repair

The replacement of damaged or lost cells and matrix with new cells and matrix that are not necessarily identical in structure and function to normal tissue.

Resection arthroplasty

A procedure in which the surfaces of diseased bone are excised, allowing fibrocartilage to grow in its place

Resorption

Process of elimination of dead or unused bone cells

Resurfer

Surfacehippy, once applied in a derogatory sense to those who were strong advocated on Totally Hip, now taken as a badge of honor.

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Revascularization

A procedure to provide an additional blood supply to fractured bone

Rheumatoid arthritis

A chronic inflammatory disease that is probably triggered by an antigen-mediated inflammatory reaction against the synovium in the joint

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RICE

A method of treatment of acute injury that is used to counteract the body's initial response to injury; RICE is an acronym for rest, ice, compression, and elevation

RBHR or RTHR

Right Birmingham Hip Resurfacing or Right Total Hip Replacement

S

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Secondary bone healing

The repair process that is characterized by the formation of fracture callus, which then remodels to form new bone

Secondary osteoarthritis

Osteoarthritis resulting from known precipitants such as bone ischemia, trauma, and neuropathy

Secondary osteoporosis

Osteoporosis characterized by conditions in which bone is lost because of the presence of another disease, such as hormonal imbalances, malignancies, or gastrointestinal disorders, or because of corticosteroid use

Septic arthritis

Infection of a joint, either bacterial or mycotic

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Shin splints

An overuse syndrome that results from cyclical loading at the posterior tibial and soleus muscle attachments onto the tibia; also known as posterior tibial stress syndrome.

Slipped capital femoral epiphysis

A unique fracture of the femoral epiphysis that fractures through the epiphysis and shifts; commonly occurs in adolescents.

Stem cells

Cells with the unlimited ability of self-renewal and regeneration; serve to regenerate tissue

Stress Shielding

Unnatural distribution of body weight to femur reduces stress to parts of femur, such shielding can lead to bone loss and possibly implant loosening

Stress fracture

An overuse injury in which the body cannot repair microscopic damage to the bone as quickly as it is induced, leading to painful, weakened bone

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Surface Hippy

Person with a hip resurfacing implant (e.g. BHR, C+, Biomet, ASR, Corin) online support group where surfacehippies share their experiences.

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Symptom

Evidence of change in body functions apparent to the patient and expressed to the examiner on questioning

Synovial fluid

A fluid that has a very low coefficient of friction and provides lubrication and nutrients for joint chondrocytes.; the straw-colored fluid in the joint that is formed by filtration of capillary plasma

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Synovial joints

A joint formed by the articulation of two bones, the ends of which are lined with hyaline cartilage and is surrounded by a capsule which is lined with synovium.

Synoviocytes

Cells that form the synovial membrane, remove debris, and secrete hyaluronic acid

Synovitis

A condition characterized by inflammation of the synovial lining

Synovium

A complex, highly permeable, and vascular tissue that lines the inner surface of joint capsules, bursae, tendons, and ligaments; the thin membrane that lines a joint capsule. There are two types of synovial cells. Type A act as macrophages and type B produce synovial fluid for joint lubrication. Marked hypertrophy of the synovium occurs with an inflammatory arthritis.

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T

Tendon

A tough, rope-like cord of fibrous tissue at both the origin and insertion of muscle; a specialized type of collagenous tissue that attaches muscle to bone. Tendons transmit forces of muscular contraction to cause motion across a joint.

THA

Total Hip Arthroplasty

THR

Total Hip Replacement

TKR

Total Knee Replacement

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Traction

Action of drawing or pullng on an object

Transcutaneous electric nerve stimulation (TENS)

A therapeutic modality that uses electrical stimulation to modulate pain, strengthen muscles, and enhance soft-tissue healing.

U

Ultrasound (Ultrasonography)

An imaging modality in which images are created from high-frequency sound waves (7.5 to 10 MHz [1 MHz = one million cycles per second]) that reflect off of different tissues. The reflected sound waves are recorded and processed by a computer and then converted into an image. Ultrasound is used to evaluate infant hip disorders and tears of the rotator cuff.

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V

Valgus

Angulation of a distal bone away from the midline in relation to its proximal partner. Genu valgum is a knock-knee deformity, with abduction of the tibia in relation to the femur. Can also be used to describe angulation of fractures or bony deformities.

Varus

Angulation of a distal bone toward the midline in relation to its proximal partner. Genu varum is a bowleg deformity, with adduction of the tibia in relation to the femur. Can also be used to describe angulation of fractures or bony deformities.

W

Wolfe’s Law

“Bone formation occurs where there is stress applied, and resorption where it is lacking