Arthrodesis (Featured Image)

Arthrodesis: Joint Fusion to Relieve Arthritis pain

Anterior ankle fusion is an open surgical procedure that fuses or joins the ankle bones together.

The ankle is the joint that connects the leg in the foot, the ankle joint includes the two lower leg bones called the tibia and fibula. And the ankle bone is called the talus.

tibia and fibulaTalus (ankle)

Together the ends of the tibia and fibula create a mortise or slot for the talus which forms the bottom of the ankle joint. Tissues called ligaments and tendons support the ankle bones ligaments attach bone to bones and tendons attach muscles to bones.

The ankle joint allows the foot to move up and down.

Articular cartilage on the ends of bones is a smooth gliding covering that allows fluid joint movement.

What is Ankle Fusion?

Ankle fusion also known as arthrodesis is a surgical procedure that joins the ankle bones together, so they no longer move or rub against each other.

Doctors may recommend this procedure for conditions that lead to severe ankle joint damage and pain.

The most common condition is osteoarthritis also known as degenerative joint disease.

In the late stage of osteoarthritis, the cartilage covering the ends of the bones has worn away exposing bare bone.

This along with the growth of bony projections called bone spurs causes swelling pain and limited movement of the joints.

Another condition that may require ankle fusion is rheumatoid arthritis, where the patient’s own immune system attacks the joints.

Any condition that destroys the joint surface such as a severe bone infection or death of bone tissue called osteonecrosis. May also require fusion of the ankle joint.

 

For more information talk to a healthcare provider.

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Types of Human Joints (Featured Image)

Types of Joints in the Human Body – Anatomy

Overview:

A joint is defined as a connection between two bones in the skeleton. There are many ways in which joints can be classified.

They can be classified according to their structure, their mobility, and their range of motion.

Joint classification:

Structure

There are three distinct types-

  • Synovial joint
  • fibrous joint
  • Cartilaginous joints

Synovial jointFibrous JointCartilaginous joint

Synovial joint:

The synovial joint as it’s the most common joint found in the human body. Synovial joints have several characteristic features as a sagittal illustration of the knee joint.

First of all, synovial joints are surrounded by an articular capsule. This capsule consists of an outer fibrous layer that helps us to stabilize the joint and an inner synovial layer that absorbs and secretes synovial fluid lubricating the joints.

synovial joints 1

The articular surfaces of a synovial joint are covered in hyaline cartilage. This cartilage is also known as articular cartilage and acts to reduce friction and assists in shock absorption.

Additional structures may also be found within synovial joints such as articular discs.

We can see examples of these in the knee joint- the medial and lateral menisci.

medial and lateral menisci

The bursae, which are small sacs lined by the synovial membrane and filled with synovial fluid.

synovial fluid

The bursae act to reduce friction caused by muscles and tendons which are located over bony joints.

The synovial joints can be further sub-classified according to the shape of their articular surfaces and their range of motion.

These include,

  • Ball and socket joint
  • Hinge joint
  • Pivot joint
  • Condylar joint
  • Saddle joint
  • Plane joint

Fibrous joint:

In a fibrous joint, the bones are bound by a tough fibrous connective tissue. These joints exhibit little to no mobility.

fibrous joint

Types of fibrous joints:

  • Sutures
  • Gomphoses
  • Syndesmoses

 

The sutures, which are fibrous joints found exclusively between the bones of the skull.

This is the coronal suture. The suture connects the frontal bone to the parietal bones via suture ligaments.

Coronal suture

Gomphosis is found in the mouth, where the roots of the teeth articulate with the dental alveoli at the dentoalveolar joints.

dentoalveolar joints

The tooth is bound into its socket by the strong periodontal ligament.

periodontal ligament

The syndesmosis, which is formed by ligaments and a strong membrane that holds two bones in place. The interosseous membrane runs between the radius and ulna.

syndesmosissyndesmosis 1

Cartilaginous joint:

In a cartilaginous joint, the bones are connected by fibrocartilage or hyaline cartilage.

These joints can be subclassified into two types

  1. Synchondroses
  2. Symphyses

 

Synchondroses or primary cartilaginous joint, where the bones are connected by hyaline cartilage.

hyaline cartilage

This type of joint is found between the diaphysis and epiphysis of a growing long bone and will eventually become completely ossified in adulthood.

The second type of cartilaginous joint is known as a symphyses or secondary cartilaginous joint, where the bones are connected by fibrocartilage.

This type of joint is found primarily along the midline of the body; for example, the pubic symphysis.

pubic symphysis

Mobility:

Diarthrosis:

A diarthrosis is a freely mobile joint, and an example of this is the knee joint which is a synovial hinge joint. It’s worth noting that every synovial joint is a diarthrosis.

 

Amphiarthrosis:

An amphiarthrosis is a slightly mobile joint, and an example of this is the pubic symphysis. Which is a secondary cartilaginous joint.

The syndesmosis, which is a fibrous joint, is also an example of amphiarthrosis.

 

Synarthrosis:

 

A synarthrosis, which is an immobile joint, and an example of this is the coronal suture of the skull.

Other examples, of this type of joint include,

  • Gomphosis
  • Synchondrosis, which is a primary cartilaginous joint.

Range of Motion:

When classifying a joint based on its range of motion, it’s important to first understand the various axes of movement that the movements are occurring along in joint movement, there are three main axes

Axes of Movement:

There are three main axes,

  1. The sagittal axis, which passes horizontally from anterior to posterior.
  2. The frontal axis, which passes horizontally from left to right.
  3. The vertical axis, which passes vertically from superior to inferior.

Types:

  • The joint that can move back and forth along a single axis is called uniaxial. Examples of these are the hinge joint and the pivot joint.
  • Joints that move about two distinct axes are called biaxial. For example, the condylar joint and the saddle joint.
  • Joints that can move through all three axes are called polyaxial or multiaxial. The only example of this is the ball and socket joint.

Synovial Joints: Anatomy

Ball and socket joint:

ball and socket joint

The ball and socket joint, which is also known as the spheroid joint.  This is the only polyaxial joint and therefore, the most mobile of all joint types.

The movements that occur at these joints are,

  • Flexion and extension, which occur around a frontal axis.
  • Adduction and abduction, which occur around a sagittal axis.
  • Internal rotation and external rotation, which occur around a vertical axis.

Two examples of this joint are the acetabulofemoral joint or the hip joint and the glenohumeral joint, which is known as the shoulder joint.

Hinge joint:

Hinge joint

The hinge joint, which is only one axis of motion making it uniaxial.

The movements that occur at these joints are,

  • Flexion
  • Extension

Two examples of these joints are the tibiofemoral joint or the knee joint and the elbow joint.

So, we use our hinge joints when we show off to flex our biceps!

Pivot joint:

Pivot joint

Like the hinge joint, the pivot joint is also uniaxial. So, pivot joints, also known as rotary joints, allow movement around a single axis –this movement being rotation.

Condylar joint:

The condylar joint, which is also known as the ellipsoid joint. Condylar joints allow movement around two axes that are at right angles to each other. Therefore, they are described as biaxial joints.

An example of this joint is the radiocarpal joint or the wrist joint.

The movements that take place at this joint are,

  • Radial deviation and ulnar deviation, which occur around the sagittal axis.
  • Flexion and extension, which occur around the frontal axis.
  • These movements combine to produce circumduction of the wrist joint.

Saddle joint: 

Saddle Joint

Similar to the condylar joint, the saddle joint is a biaxial joint.

The movement that takes place at this joint is,

  • Abduction and Adduction
  • Flexion and Extension
  • Circumduction

An example of such a joint is the Carpometacarpal joint of the thumb.

Plane joint:

Plane joint

The plane joint is also known as the gliding joint. The plane joint performs a sliding or a gliding movement, where one bone moves across the surface of another.

An example of this joint is the acromioclavicular joint, which increases the flexibility of the shoulder.

 

For more information talk to a healthcare provider.

If you have any questions about Types of joints in Humans, please feel free and leave a comment.

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Causes of Hip Pain (Featured Image)

Causes of Hip Pain

What are the common causes of hip pain?

Pain can arise from the structures that are within the hip joint or from the structures surrounding the hip joint. The most important thing is to ask the patient to locate the site of pain.

Ask the patient to point at the site of pain. When the patient states that their hip hurts, it doesn’t mean that the pain is coming from the hip joint itself, so ask the patient to point at the site of the pain.

The pain can arise from structures that are within the hip joint or from structures surrounding the hip.

The hip joint is a weight-bearing joint. The joint consists of two main parts: the femoral head (ball) and the acetabulum (socket).

  • The hip pain can be anterior hip pain (deep groin pain).
  • The pain can be lateral hip pain.
  • The pain can be posterior hip pain.
  • The pain can be far posterior hip pain, coming from the sacroiliac joint and the lower spine.

Anterior hip pain is usually deep within the groin, and it can result due to arthritis of the hip.

Treatment:

Conservative treatment is:

  • physical therapy
  • anti-inflammatory medication
  • possible injections
  • Surgery (Is done in late cases, usually by a total hip replacement.)

 

It is usually diagnosed by clinical examination with a provocative test of flexion, adduction, and internal rotation. The diagnosis is confirmed by an MRI arthrogram.

Conservative Treatment:

  • Therapy
  • Anti-inflammatory medication
  • Injections

Surgical Treatment:

  • Provides good results.
  • Usually done by arthroscopic debridement or repair of the tear.

Diagnosis:

A stress fracture is usually diagnosed by an MRI. The x-ray may be normal. Early diagnosis is important before the fracture displaces and gives a bad result.

Avascular Necrosis (AVN)

Treatment of avascular necrosis is usually surgical fixation of the fracture. Fixation of the fracture is usually performed utilizing screws. Femoral head replacement is done in rare, late cases.

Avascular necrosis means the death of a segment of the bone. When the blood supply of the femoral head is interrupted, a segment of the bone dies and becomes necrotic (femoral head will collapse).

AVN

Treatment for early stages of AVN without collapse of the femoral head includes decompression by drilling of this segment in the femoral head to bring a new blood supply to the area.

The vascularized fibular graft may be used also. In severe cases with the collapse of the femoral head (usually diagnosed by an x-ray), the treatment is usually total hip replacement.

Treatment of an inflamed bursa is usually the conservative treatment of physical therapy, anti-inflammatory medication, and injection. Surgical treatment by excision of the bursa is rarely done.

In case of chronic, resilient trochanteric bursitis, try to get an MRI to exclude a tear of the abductor muscles of the hip (gluteus medius and gluteus minimus muscle tear).

Lateral-hip-pain

Posterior hip pain is usually due to piriformis syndrome. The sciatic nerve can be irritated from piriformis syndrome.

Treatment is:

  • Usually physical therapy
  • Stretching
  • Anti-inflammatory medications
  • Injections

Surgical treatment is usually rare:

  • It is the last resort.
  • It includes the release of the piriformis tendon and exploration of the sciatic nerve.
  • It is done in cases that fail to improve with conservative treatment.

Posterior Hip Pain:

Far posterior pain may come from the sacroiliac joint or from the lower spine conditions. Sacroiliac joint (SI) problems are a challenging diagnostic and treatment entity.

There are a lot of clinical diagnostic examinations that can be used to diagnose sacroiliac joints (SI) problems such as the Faber test and others.

However, injection of the SI joint is probably the method to diagnose pain originating from the SI joint. If there is an improvement of the condition of the patient after injection of the SI Joint, then we will probably consider that the problem is in the SI joint.

The SI joint problems are usually underestimated and are unappreciated. Lower spine conditions can cause referred pain to the buttock and hip area.

In fact, symptoms of hip and lower spine conditions can overlap or both of them can coexist in the same patient. You have to separate pain from the hip from the pain that comes from the spine.

 

For more information talk to a healthcare provider.

If you have any questions about Hip Pain, please feel free and leave a comment.

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Food for Joint Pain (Featured Image)

Diet For Joint Pain – Best Foods for people with Arthralgia

Chronic joints pain affects millions of people across the world every year. Thousands of patients routinely seek medical attention for joint pain, and it is one of the leading causes of disability.

To give you an estimate of the disease, in 2002, about 10.5 million people in the United States of American said they experienced severe joint pain, but by 2014 that number had jumped to 14.6 million, said a researcher from the U.S. Centers for Disease Control and Prevention.

Severe Joint pain can limit a person’s ability to perform basic functions and seriously compromise their quality of life.

Joint pain in medical terms is known as ‘arthralgia’. Which is as common as the flu, and can be caused by a wide range of problems – such as,

  1. Bad Posture
  2. Overuse and misuse of joints like in the case of athletes such as footballers, sprinters, and tennis players.
  3. Nutritional deficiencies in the diet.
  4. Osteoarthritis.
  5. Rheumatoid arthritis.
  6. Certain neurological problems.
  7. Kidney and liver problems.

Luckily with strict precautions, good exercise, proper diet, and supplementation. Joint pain can be managed.

 

The number one food that we have on our list for people with chronic joint pain is:

1. Oily Fish:

Fish oil

Oily fish can reduce joint pain and morning stiffness as it contains unsaturated fats such as Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA). EPA and DHA also limit the production of certain negative proteins that inhibit certain types of arthritis.

The Omega-3 fatty acids present in fish also increase blood flow throughout the body during exercise, which can help reduce joint pain and swelling.

It is recommended that each person should consume at least two to four weekly servings of fish like salmon and sardines.

It’s hard for many people to consume such quantities. Hence, omega-3 fish or krill oil supplements can help support joint health.

2. Walnuts & Brazil Nuts:

Brazil nuts

Like oily fish, walnuts are a rich vegetarian alternative source of omega- 3 fatty acids, which reduce inflammation. Also eating walnuts regularly can lower cholesterol, relax blood vessels to lessen stress on the heart, and reduce blood pressure.

Also, Brazil nuts are high in selenium, which improves the quality of cartilage proteins present in our bones and joints. Snack on 3 or 4 each day and you should get all they required. Selenium also helps to boost your immunity which is very important considering the pandemic.

3. Dark Green Leafy Vegetables:

Dark Green Leafy vegetables

Broccoli, cauliflower, and cruciferous vegetables have been shown to protect against the development of arthritis and joint pain.

These also contain antioxidants like carotenoids, which fight free radicals in the body and prevent damage to our cells and tissues. Not only do free radicals damage our cells, but they also have been linked to rheumatoid arthritis (RA) and inflammation.

Green, leafy vegetables such as broccoli, spinach, Brussels sprouts, kale, Swiss chard are packed with antioxidants and vitamins A, C, and K, which protect cells from free-radical damage.

These foods are also high in bone-preserving calcium.

 

4. Onion & Garlic:

Garlic.

Onions are a rich source of quercetin, an antioxidant that works to reduce inflammation. Red onions are particularly high in antioxidants.

Garlic contains allicin, a compound that can help to alleviate symptoms of rheumatoid arthritis.

Garlic also contains Diallyl Di-sulphide which is highly effective for the body and can help you with a number of diseases include joint pain.

 

5. Bone Broth:

bone broth

Glucosamine, chondroitin, and amino acids are well documented to help maintain healthy joints, while calcium is essential for bone density. Bone broth contains all of these.

The gelatin-like substance that comes from cooking bones mimics collagen that occurs naturally in our joints, tendons, and ligaments.

Taken regularly as an oral supplement, it has been known to reduce joint pain and increase function for people with arthritis.

 

For more information talk to a healthcare provider.

If you have any questions about Diet for Joint Pain, please feel free and leave a comment.

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