Orthopaedics
Roy Palmer, Diana Wetherill in Medicine for Lawyers, 2020
Figure 13.1 shows the various parts of the bone, which may need further description. A long bone, such as the tibia (shin bone) or humerus (the upper arm bone), or short long bones, such as the metacarpals (the bones you see on the back of the hand) and metatarsals (in the feet) are divided up into several parts for descriptive purposes. At either end is an epiphysis. The periosteum is an outer membrane of bone-forming tissue and this assists with growth during the growing period and is also responsible for laying down bone during fracture healing throughout the patient’s life. Endosteum is a similar lining of tissue within the bone between the compact (or hard) outer bone and the spongy bone of the medullary cavity (the marrow of the bone). Where a bone takes part in a joint it is covered by what is known as articular cartilage. A bone derives its nutrition from the nutrient arteries that reach it either by perforating the hard outer bone (the cortex) or by way of the joint capsules, which are connected to the bone near the edges of the joint.
The Anatomy of Joints Related to Function
Verna Wright, Eric L. Radin in Mechanics of Human Joints, 2020
Stability is a dynamic concept and depends crucially upon maintaining adequate joint compression to overcome actual or potential distraction forces. Traditionally, factors maintaining joint stability are regarded as the shape of the articular surfaces, ligaments, and muscles. Only the hip joint has articular surfaces that are inherently stable in the absence of any other factors, the acetabular labrum gripping the femoral head just beyond its equator. Most ligamentous fibers are tight in only one position of a joint, often at the limit of motion, and most joints do not normally operate at these extremes in locomotor activities. Muscles are critically important stabilizing factors in the great majority of joints, particularly in the plane(s) of motion(s) (86,87).
Lower Extremity Surgical Anatomy
Armstrong Milton B. in Lower extremity Trauma, 2006
The proximal tibia has massive medial and lateral condyles, an intercondylar area, and a tibial tuberosity. The medial articular surface is oval and centrally concave, whereas the lateral surface is round and centrally concave. The tibial tuberosity is the apex of the anterior triangular area where the condylar surfaces merge. The anterior intercondylar area is smooth and receives the anterior cruciate ligament, whereas the posterior intercondylar area is where the posterior cruciate ligament attaches. The condyles overhang the shaft, which is triangular with mediallateral and posterior surfaces. On the posterior surface, there is an oblique soleal line that the popliteus attaches to superiorly. Distal to the soleal line and coursing vertically is the vertical line, which separates the flexor digitorum longus (FDL) (medial) and tibialis posterior. The distal tibia expands and is laterally rotated. It has a posterior, anterior, medial, and lateral surface. The lateral surface possesses the fibular notch, which supports the interosseous membrane. The interosseous membrane has a window proximally where the anterior tibial artery (AT) penetrates anteriorly. Distally a window in the membrane exists for perforating branches of the peroneal artery. Ossification of the tibia occurs at three centers: the shaft and both epiphyses.
Secondary hip dysplasia increases risk for early coxarthritis after Legg-Calve-Perthes disease. A study of 255 hips
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2019
Andrej Moličnik, Jošt Janša, Boštjan Kocjančič, Veronika Kralj-Iglič, Drago Dolinar
We described the shape of the articular surface as a rotationally symmetric body, similar to an ellipsoid. However, as the region of the femoral head which bears most of the weight in the one-legged stance is located laterally and superiorly, we considered that the shape of the contour of the articular surface in the frontal plane is circular with the radius of the circle fitted to the curvature of the femoral head and the acetabulum in the range of the load bearing. In the hips with deformed femoral heads, there is considerable flattening of the head and acetabulum in that region, therefore, the radius of the articular surface circle in the frontal plane is large, and does not fit the contour of the femoral head medially and inferiorly. To obtain the shape of the articular surface which fits the joint optimally, the contour in the sagittal plane was taken to be quasi-elliptical. The appearance of the femoral head, however, is quasi-elliptical in the frontal plane and spherical in the sagittal plane. It should be born in mind that the articular surface is an abstract feature that is subject to the weight bearing and, therefore, outlines a particular region of the femoral head and the acetabulum. However, the deformation of the articular surface corresponds to the deformed appearance of the femoral head, considered by some authors who previously analysed development of hips after LCPD (Rowe et al. 2005; Shah et al. 2013).
Shedding light on experimental intra-articular drugs for treating knee osteoarthritis
Published in Expert Opinion on Investigational Drugs, 2023
Yang Zhao, Qianhua Ou, Yu Cai, Guangfeng Ruan, Yan Zhang, Changhai Ding
There are several advantages of IA delivery. First, it can largely decrease the risk of adverse events from oral analgesics [14]. Second, it can bring a sufficient dose of drugs into the joint, making it more cost-effective [2]. Third, it allows highly targeted components to access the joint, making it possible to develop articular-targeting strategies. Last, as a minimally invasive treatment, IA injection is commonly accepted by patients, especially those undergoing repeated administrations [15]. Currently, IA administration of corticosteroids and hyaluronic acid are two Food and Drug Administration (FDA)-approved and frequently prescribed treatments for pain control and viscosupplement, respectively [16,17]. Nonetheless, their efficacy is controversial regarding the mixed outcomes in pain control and risk of cartilage toxicity [18,19].
Analytical review on the biocompatibility of surface-treated Ti-alloys for joint replacement applications
Published in Expert Review of Medical Devices, 2022
Joint replacement is a surgical procedure in which an artificial joint surgically replaces arthritic or damaged joints made up of metals or plastic components. Damage to the joint may be caused due to several reasons such as aging, accident, or osteoarthritis. So, such damage causes orthopedic surgery that generally requires internal fixation of joints to provide stability during the bone healing process. Historically, cemented and cementless implant designs were used for total joint replacement (TJR) [1]. Cementless techniques are achieving more attention and popularity for TJR due to the removal of the second surgery requirement in cemented implants [2]. In cemented technique, initially, implants possess excellent mechanical strength, but later osteolysis causes loosening of implants. The biological response of cementless implants provides long-term mechanical stability. These implants’ stability depends on several parameters, such as corrosion behavior, debris created, and ions released from the implant. So, bone adaptation to implant and stress shielding is the central areas of concern [3].