Arthritis

Arthritis is a group of conditions involving damage to the Joints of the body and is the leading cause of disability in people older than fifty-five years.

There are different forms of Arthritis; each has a different cause. The most common form of Arthritis, osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age.

Bilateral

The right and left sides of a structure or plane.

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Chondromalacia Patellae

Chondromalacia Patellae (also known as CMP, Patello-femoral Pain Syndrome, or Runner’s Knee) is a degenerative condition of the cartilage surface of the back of the knee cap, or Patella. It produces discomfort or dull pain around or behind the Patella. It is common in young adults, especially soccer players, cyclists, rowers, tennis players, ballet dancers and runners. Snowboarders are particularly prone to this injury, especially those specializing in jumps where the knees are under great stress. The condition may result from acute injury to the Patella or from chronic friction between the Patella and the groove in the femur through which it passes during motion of the knee. CMP specifically refers to a knee that has been structurally damaged, while the more generic term Patello-femoral Pain Syndrome refers to the earlier stages of the condition, where symptoms might still be fully reversible.

Extension

Extension is a movement of a joint. For example, Extension is produced by extending the flexed elbow. The arm is now straight; it has been extended. If the head is tilted all the way back, it is said to be extended.

The movement in the opposite directions is called Flexion. Flexion decreases the angle between the bones of the limb at a joint, while Extension increases it.

Flexion

In anatomy, Flexion is a position that is made possible by the joint angle decreasing. The skeletal (bones, cartilage, and Ligaments) and muscular (Muscles and tendons) systems work together to move the joint into a "flexed" position. For example the elbow is flexed when the hand is brought closer to the shoulder. The trunk may be flexed toward the legs or the neck to the chest.

The opposite term is Extension, or straightening. Flexion decreases the angle between the bones of the limb at a joint, and Extension increases it.Note that specific Flexion activities may occur only along the sagittal plane, i.e. from the forward to backward direction, and not side-to-side direction, which is further discussed in abduction.

Haematomas

A hematoma, or haematoma, is a collection of blood, generally the result of hemorrhage, or, more specifically, internal bleeding.

Hematomas exist as bruises (ecchymoses), but can also develop in organs. Some hematomas form into a welt-like formation that is hard to the touch, which is a sac of blood that the body creates to keep internal bleeding to a minimum. In most cases the sac of blood eventually dissolves; however, in some cases they may continue to grow or show no change. If the sac of blood does not disappear it may need to be surgically removed. It is not to be confused with hemangioma which is an abnormal build up of blood vessels in the skin or internal organs.

Hematomas can gradually migrate, as the effused cells and pigment move in the connective tissue. For example, a patient who injures the base of his thumb might cause a hematoma, which will slowly move all through the finger within a week. Gravity is the main determinant of this process.

Hamstring

In human anatomy, a Hamstring refers to one of the tendons that makes up the borders of the space behind the knee.

Joints

Joints is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally.

Ligaments

In anatomy, the term ligament is used to denote three different types of structures:

1. Fibrous tissue that connects bones to other bones. They are sometimes called "articular Ligaments", "fibrous Ligaments", or "true Ligaments".
2. A fold of peritoneum or other membrane
3. The remnants of a tubular structure from the fetal period of life
The first meaning is most commonly what is meant by the term "ligament".

Muscles

Muscle is contractile tissue of the body and is derived from the mesodermal layer of embryonic germ cells.

Muscle cells contain contractile filaments that move past each other and change the size of the cell. It is classified as skeletal, cardiac, or smooth muscle, and its function is to produce force and cause motion, either locomotion or movement within internal organs.

Much of muscle contraction occurs without conscious thought and is necessary for survival, like the contraction of the heart, or peristalsis (which pushes food through the digestive system). Voluntary muscle contraction is used to move the body, and can be finely controlled, like movements of the eye, or gross movements like the Quadriceps muscle of the thigh.

There are two broad types of voluntary muscle fibers, slow twitch and fast twitch. Slow twitch fibers contract for long periods of time but with little force while fast twitch fibers contract quickly and powerfully but fatigue very rapidly.

Patella

The Patella or kneecap is a thick, triangular bone which articulates with the femur and covers and protects the front of the knee joint. It is the largest sesamoid bone in the human body. It is attached to the tendon of the Quadriceps femoris muscle, which contracts to straighten the leg. The vastus intermedialis muscle is attached to the base of Patella. The vastus lateralis and vastus medialis are attached to lateral and medial borders of Patella respectively.

Post Arthroscopy

Knee arthroscopy has in many cases replaced the classic arthrotomy that was performed in the past. Today knee arthroscopy is commonly performed for treating with damaged meniscus cartilage, reconstruction of the anterior cruciate ligament and for cartilage microfracturing. Arthroscopy can also be performed just for diagnosing and checking of the knee; however, the latter use has been mainly replaced by magnetic resonance imaging.During an average knee arthroscopy, a small fiberoptic camera, the endoscope, is inserted into the joint through a small incision, about 4 mm (1/8 inch) long. A special fluid is used to visualize the joint parts. More incisions might be performed in order to check other parts of the knee. Then other miniature instruments are used and the surgery is performed.Recovery after a knee arthroscopy is a lot faster compared to arthrotomy. Most patients can return home and walk using crutches the same or the next day after the surgery. Recovery time depends on the reason that surgery was needed and the patient’s physical condition. Usually after a month a patient can fully load his leg and after a few weeks the joint function can fully recover. It is not uncommon for athletes who have a beyond average physical condition to return to normal athletic activities within a few weeks.Arthroscopic surgeries of the knee are done for many reasons, but the usefulness of surgery for treating osteoarthritis is doubtful. A double-blind placebo-controlled study on arthroscopic surgery for osteoarthritis of the knee was published in the New England Journal of Medicine in July 2002.

In this three-group study, 180 military veterans with osteoarthritis of the knee were randomly assigned to receive arthroscopic débridement with lavage, just arthroscopic lavage, or a sham surgery, which made superficial incisions to the skin while pretending to do the surgery. For two years after the surgeries, patients reported their pain levels and were evaluated for joint motion. Neither the patients nor the independent evaluators knew which patients had received which surgery. The study reported that "At no point did either of the intervention groups report less pain or better function than the placebo group." Because there is no confirmed usefulness for these surgeries, many agencies are reconsidering paying for a surgery which seems to create risks with no benefit.

Quadriceps

The Quadriceps femoris (Quadriceps, Quadriceps extensor, guads or quads) includes the four prevailing Muscles on the front of the thigh. It is the great extensor muscle of the knee, forming a large fleshy mass which covers the front and sides of the femur.It is subdivided into separate portions, which have received distinctive names.

Rectus femoris occupies the middle of the thigh, covering most of the other three Quadriceps Muscles. It originates on the ilium. It is named from its straight course.

The other three lie deep to rectus femoris and originate from the body of the femur, which they cover from the trochanters to the condyles:

• Vastus lateralis is on the lateral side of the femur.
• Vastus medialis is on the medial side of the femur.
• Vastus intermedius lies between vastus lateralis and vastus medialis on the front of the femur.

All four parts of the Quadriceps muscle attach to the Patella via the Quadriceps tendon.The Quadriceps is also involved in Lombard’s Paradox.

Swelling

Swelling (medical) is the enlargement of organs caused by accumulation of excess fluid in tissues

Tendonitis

Tendinitis or Tendonitis is a painful inflammation of a tendon. Generally tendinitis is referred to by the body part involved, such as Achilles tendinitis (affecting the Achilles tendon), or patellar tendinitis (jumper’s knee, affecting the patellar tendon). Chronic overuse of tendons leads to microscopic tears within the collagen matrix, which gradually weakens the tissue.

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Trochanteric bursitis

Trochanteric bursitis is inflammation of the trochanteric bursa.This bursa is situated adjacent to the femur, between the insertion of the gluteus medius and gluteus minimus Muscles into the greater trochanter of the femur and the femoral shaft. It has the function, in common with other bursae, of working as a shock absorber and as a lubricant for the movement of the Muscles adjacent to it.Occasionally, this bursa can become inflamed and clinically painful and tender. This condition can be a manifestation of rheumatoid Arthritis or of an injury, but sometimes arises for no obviously definable cause. The symptoms are pain in the hip region on walking, and tenderness over the upper part of the femur, which may result in the sufferer being unable to lie in comfort on the affected side.