Chapter 9 (4)

• The knee is highly vulnerable to rotational and horizontal stress. The most common injuries happen to the menisci and anterior cruciate ligament (ACL), and they heal slowly due to scanty blood flow.
• Arthroscopy is a minimally invasive surgical procedure that involves the use of an arthroscope, which is a small camera that is inserted into the joint through a small incision. The arthroscope sends images to a video screen, allowing the surgeon to see inside the joint and diagnose and treat any problems. It has less tissue damage than conventional surgery, helps the injury recover more quickly, and with an Arthroscopic ACL repair it takes about 9 months for the healing to be complete.
• The talocrural (ankle) joint includes two articulations; the medial joint which is between the tibia and the talus and the Lateral joint which is between the fibula and the talus. Both articulations are enclosed by one joint capsule. The malleoli of the tibia and fibula overhang the talus on either side and prevent side-to-side motion. It has a more restricted range of motion than the wrist.
• Ankle ligaments include; the anterior and posterior tibiofibular ligaments which bind the tibia to the fibula. the multipart medial (deltoid) ligament that binds the tibia to the foot on the medial side. The multipart lateral (collateral) ligament that binds the fibula to the foot on the lateral side. The calcaneal (Achilles) tendon extends from the calf muscles to the calcaneus and it plantarflexes the foot and limits dorsiflexion.
• Sprains (torn ligaments and tendons) are common at the ankle and usually involve pain and immediate swelling.
• Arthritis is a broad term for pain and inflammation of the joints. It is the most common crippling disease in the United States. Rheumatologists are physicians who treat arthritis and other joint disorders.
• Osteoarthritis (OA) is the most common form of arthritis, it is the “Wear-and-tear arthritis” and results from years of joint wear. It is accompanied by crackling sounds called crepitus and in this arthritis, the articular cartilage softens and degenerates. Bone spurs develop on exposed bone tissue causing pain.
• Rheumatoid arthritis (RA) is an autoimmune attack against the joint tissues. In this arthritis, misguided antibodies (rheumatoid factor) attackthe synovial membrane, enzymes in synovial fluid degrade the articular cartilage, and then the joint begins to ossify. Ankylosis makes a solidly fused, immobilized joint. Although remissions occur, steroids and aspirin control inflammation. Arthroplasty is the replacement of the diseased joint with an artificial device called a prosthesis.