Terminology used in connection with Hip Problems and Hip Resurfacing
Please report to me any additions or corrections
Ron van Mierlo
Short	Name	Picture	Swedish general name	Type/example/recommended	Explanation	Implications / additional info	URL
HR	Hip Resurfacing	Pict.			There is no one proper name or abbreviation for the procedure whereby the hip joint is resurfaced. This causes a fair amount of confusion. Some of the abbrivated forms do even exist for completely different procedures. As example: "HR" can mean "Hip Resurfacing" but also "Hemi Resurfacing", the first describing the total hip resurfacing and the second describing resurfacing of only the femur! Another example: "THR" is used for "Total Hip Replacement" (the traditional hip prosthesis) but also "Total Hip Resurfacing". Therefore can only the context in which an abbreviation is used clarify the meaning it is given.
HRS	Hip Resurfacing
HR	Hemi Resurfacing	Pict.	Förvirrande?	Confusing?
HA	Hemi Arthroplasty		Med dessa 21 namn för metoden med ytersättning skapas en del förvirring! Akta den röd markerade delen, den gäller endast en resurfacing av benkulan och medför hastig förslitning av kvarvarande brosket i leden och nödsaken att operera igen! "THR" används även för traditionella protesen så den är ännu mer förvirrande! Försäkra er också att ni förstår vilka nackdelar "partial hip resurfacing" har, som finns längre ner i den här listan !	The 21 names on the left are those that I found so far for this method, hopefully it will stay at the figure 21! Just note the red marked part that applies to a resurfacing of the femoral head only and has been known to cause rapid wear of the cartilage in the joint and the need for new operation! "THR" is also used for the traditional hip prosthesis, causing extra confusion! Make sure also that you know what the disadvantages are of the so-called "partial hip resurfacing", taken up further down in this list !
HSR	Hemi Surface Replacement
PR	Partial Resurfacing	Pict.
THR	Total Hip Resurfacing	Pict.
PHR	Partial Hip Resurfacing	Pict.
HSR	Hip Surface Replacement	Pict.
SHR	Surface Hip Replacement						A page with information and a table on different resurfacing options and makes
HRA	Hip Resurfacing Arthroplasty
RHA	Resurfacing Hip Arthroplasty
MoMHR	Metal-on-Metal Hip Resurfacing
RTHA	Resurfacing Total Hip Arthroplasty
SRA	Surface Replacement Arthroplasty
THRA	Total Hip Resurfacing Arthroplasty
MMSR	Metal-on Metal Surface Replacement
MoMRA	Metal-on-Metal Resurfacing Arthroplasty
MoMHRA	Metal-on-Metal Hip Resurfacing Arthroplasty
MoMRHA	Metal-on-Metal Resurfacing Hip Arthroplasty
MoMTHRA	Metal-on-Metal Total Hip Resurfacing Arthroplasty
	3-D Computer surgery					See also: CAS and IGS
	Abduction				The ability to move an arm or leg away from the body
	Abductor muscles				Any muscles that pull a body part away from the body	The hip abductor muscles are: Gluteus Maximus, Gluteus Medius, Gluteus Minimus. Tensor Fascia Lata
AIS	Abbreviated Injury Scale
AA	Acetabular Angle (of Sharp)	Pict.			Measures the acetabular inclination or opening. The angle is formed between a horizontal line and a line from the teardrop to the lateral acetabulum. Normal: 33 - 38 degrees	Also called the "Acetabular Index"
	Acetabular component				Aiming at the cup shaped implant that is placed in the for this purpose adapted pelvic socket	Used with most hip operations
	Acetabular Cup Extractor				A universal or dedicated tool for the extraction of acetabular cups. Depending on make and type cup the extractor needs to be adapted to fit the holes or ridges on which the extractor needs to hook or grip. A sliding hammer is many times fitted to the extractor if not integrated in the extractor already.
	Acetabular dysplasia				With acetabular dysplasia the hip socket is a shallow and abnormally directed. The condition is most commonly associated with a subtle abnormality of the hip joint at birth (congenital hip dislocation) and often remains undetected for many years. Sometimes acetabular dysplasia can develop as the result of other childhood hip conditions such as infection, trauma or Perthes disease	The hip socket is shallow and remains shallow, so that the hip is unstable, unless a correcting osteotomy is applied
	Acetabular Floor
	Acetabular fossa				A depressed area in the floor of the acetabulum above the acetabular notch which serves as attachment point for the ligamentum teres from the femur onto the acetabulum	Latin: fossa acetabuli
AHI	Acetabular head index	Pict.
AH	Acetabular height				The greatest distance of the acetabular cup between the top and the bottom
	Acetabular Index				See: "Acetabular Angle"
	Acetabular labrum	Pict.			See: "Acetabular lip"
	Acetabular lip	Pict.				Synonym to: labrum acetabulare, circumferential cartilage, cotyloid ligament, ligamentum cotyloideum
	Acetabular membrane	Pict.
	Acetabular retroversion				A form of hip dysplasia characterized by abnormal posterolateral orientation of the acetabulum. This pathophysiology predisposes the individual to subsequent anterior impingement of the femoral neck upon the anterior acetabular margin and fibrous labrum. Without treatment, cases may progress to damage of the anterior labrum and cartilage, with eventual early onset of osteoarthritic disease
	Acetabular tilt osteotomy
ATD	Acetabular Trochanter Distance				The distance between the acetabular rim and the greater trochanter
	Acetabulum	Pict.	Ledpanna		A deep, cup-shaped, hemispherical depression, directed downward, lateralward, and forward. It is formed medially by the pubis, above by the ilium, laterally and below by the ischium; a little less than two-fifths is contributed by the ilium, a little more than two-fifths by the ischium, and the remaining fifth by the pubis. It is bounded by a prominent uneven rim, which is thick and strong above, and serves for the attachment of the glenoidal labrum (cotyloid ligament), which contracts its orifice, and deepens the surface for articulation. It presents below a deep notch, the acetabular notch, which is continuous with a circular non-articular depression, the acetabular fossa, at the bottom of the cavity: this depression is perforated by numerous apertures, and lodges a mass of fat. The notch is converted into a foramen by the transverse ligament; through the foramen nutrient vessels and nerves enter the joint; the margins of the notch serve for the attachment of the ligamentum teres. The rest of the acetabulum is formed by a curved articular surface, the lunate surface, for articulation with the head of the femur	The pelvic hip joint socket into which the head of the femur fits
AHQ	Acetabulum Head Quotient					from Heyman
ADL	Activity of daily living
ARF	Acute renal failure				Kidney failure that happens suddenly, where something has caused the kidneys to shutdown. This may be due to infection, drugs (prescription, over-the-counter, recreational), traumatic injury, major surgery, nephrotoxic poisons, etc. Emergency dialysis may be needed until the situation resolves and the kidneys begin functioning again. This might take a short time, or months, or it might be permanent
	Adaptive remodelling				Adaptive remodelling is the abnormal growth of a bone that can occur when it is exposed to too much stress (the opposite of Stress Shielding)
	Adduction				The ability to move an arm or leg toward the body
Adept	Adept		Adept		Name for the whole "Adept" system from the manufacturer Finsbury. An "Adept" resurfacing prosthesis co-exists besides an "Adept" large head that can be placed on a shaft for the THR patients.	By hearing "Adept" the patient still has to confirm with his/her orthopaedic surgeon whether a resurfacing of head-on shaft is intended. Please check this to prevent disappointment after the operation!
AIS	Adolescent Idiopathic Scoliosis
ARDS	Adult Respiratory Distress Syndrome
ATLS	Advanced Trauma Life Support
ARMD	Adverse Reactions to Metal Debris
	Aetiology				The science on the source or origin (of a disease for instance)	See also: "Etiology"
	Aetiopathology				Consideration of the cause of an abnormal state or finding	See also: "Etiopathology"
	Agenesis		Agenesis		The absence of an organ, limb or joint. For example "femoral agenesis".	In rare cases a patient can miss an acetabulum, the femoral head and the whole femur. It is thought to originate from faillure to develop in the embryo stage.
	Agonist		Agonist		A muscle or muscle group that crosses limb joints and by its own contraction or actively can cause a movement of the crossed limb(s). The opposing antagonist muscle is relaxed at this point.
ARA	Agora Roentgenographic assessment
ALN	Alendronate				A bisphosphonate used for the treatment of osteoporosis, Paget's disease of bone and osteoporosis caused by steroid treatment. Fosamax is one brand name for oral products containing alendronate
ALP	Alkaline phosphatase
	Allodynia				Pain due to a stimulus that does not normally provoke pain
	Allogeneic blood transfusion		Allogenisk blodtransfusion		Allogeneic or homologous transfusion is transfusion of blood collected from someone other than the patient. Allogeneic blood transfusion has been associated with an increased incidence of postoperative infection; consequently, a universal white blood cell (WBC)-filtered reduction technique now is commonly used to prepare allogeneic blood transfusions
	Allograft		Allograft		Graft tissue, bone or ligament/tendon, that is taken from a deceased person who donated tissue for implantation in other patients that have one or other tissue deficiency. Allergic responses to foreign tissue are prevented by processing of tissue so that the proteins are removed. Thus, for example, bone allografts do not have proteins, just the calcium and supporting structure that can be very helpful in rebuilding bone loss in complex hip and knee replacements
	Alumina				A type of ceramic material used in orthopaedic (usually total hip) bearings. The wear rate of alumina ceramic bearings is better than anything else in total hip replacements. When people refer to ceramics in joint replacement surgery, they usually mean alumina, since this is the most common type of ceramic now used in hip replacement surgery. It is not used in knee replacements yet. While there is a theoretical risk of an alumina bearing breaking in the body, this risk is so small with modern biomaterials that it is essentially a theoretical consideration
	Ambidextrous				The ability to pick up where the surgeon has left off
	Ambulatory				Able to move around
AAOS	American Academy of Orthopaedic Surgeons						www.aaos.org
AAHKS	American Association of Hip and Knee Surgeons						www.aahks.org/index.asp/fuseaction/patients.locator
	Analgesia				Absence of pain in response to stimulation that would normally be painful
AML	Anatomical Medullary Locking
	Anesthesiologist				A physician who has special training in the branch of medicine that deals with anesthesia
	Angiogram	Pict.			A set of x-ray-like pictures that are taken to diagnose narrow, blocked, enlarged, or malformed arteries or veins in many parts of the body, including the brain, heart, abdomen, and legs
AS	Ankylosing spondylitis				A rheumatic disease that causes arthritis of the spine and sacroiliac joints and can cause inflammation of the eyes, lungs, and heart valves. It varies from intermittent episodes of back pain that occur throughout life to a severe chronic disease that attacks the spine, peripheral joints and other body organs, resulting in severe joint and back stiffness, loss of motion and deformity as life progresses	AS can also cause inflammation in other joints
	Ankylosis				An abnormal immobility and consolidation within a joint leading to stiffness or even fixation	Chronic joint inflammation
	Antagonist				A muscle or muscle group that returns the affected limb(s) to its original postion after having been contracted by the agonist muscle. The opposing agonist muscle is relaxed at this point.
	Antalgic limp				A posture or gait assumed in order to avoid or lessen pain
AFN	Antegrade Femoral Nail				A long intramedullary nail type that can be used with differing and multiple femoral fractures	See also "FAN"
AAHI	Anterior Acetabular Head Index	Pict.
	Anterior approach				This is a term used by surgeons who do hip replacement surgery.  It refers to the exact route the surgeon must take to reach the hip joint.  In the United States, when surgeons say “anterior approach” they commonly refer to the lateral approach
	Anterior Center-Edge Angle (of Lequesne)	Pict.			Measures anterior dysplasia on the false profile view (represents a true lateral of the socket and allows assessment of the  degree of femoral head anterior (un)coverage.). Angle formed by intersection of a vertical line through the center of the femoral head and a line extending through the center of the femoral head to the anterior sourcil. Normal: 25 - 50 degrees; <20 is diagnostic of DDH
	Anterior compartment syndrome				A condition with oedema in the anterior compartment of the ipsilateral leg, that can occur after hip surgery. Causes include: the crushing of the gluteal muscles during longer surgery in the lateral decubitus position, post-ischaemic swelling after occlusion of the vessels during long surgery and vigorous repetitive stretching of the muscles of the anterior compartment from the intraoperative use of electrical calf stimulators	Early diagnosis and management of acute compartment syndrome are critical for the prevention of long-term disability. Diagnosis may be delayed when the condition is unexpected and when the symptoms are hidden through use of analgesia. Increasing the rate of the epidural infusion soon after pains first develop may give misleading clinical symptoms
ACL	Anterior Cruciate Ligament				A ligament that connects the upper leg bone (femur) to the lower leg bone (tibia)
	Anterolateral				In front and away from the middle line
AP or a.p.	Anteroposterior				The AP view is commonly used when the hips are x-rayed
	Anteversion				The position of the femoral head and neck in more forward direction	An acetabular cup should for example have some anteversion to prevent impingement and groin pain
ABC	Antibiotic bone compound
	Antibiotic prophylaxis			Cefazolin, Vancomycin,  Cefotetan, Aminoglycosides, Cefoxitin, Metronidazole, Clindamycin, Ciprofloxacin	Refers to the use of antibiotics as a measure to  prevent infections	Can reduce the incidence of surgical wound infection
ALAC	Antibiotic-loaded acrylic cement					Data exist suggesting the potential for the development of bacterial antibiotic resistance. Therefore the use of antibiotic-impregnated cement should only be performed for clear indications. Research showed from 91 total hip replacements that were infected with coagulase-negative Staphylococcus that out of the patients who had had antibiotic cement in their reconstruction, 88% had development of resistant bacteria, whereas in patients who had not received antibiotic cement only 16% had resistant bacteria
ALACS	Antibiotic-loaded articulating cement spacer					see ALAC
AbBGF	Antibiotic-loaded bone graft
AMB	Antibiotic-loaded morcellized bone graft
	Antibody				A special protein produced by the body's immune system that recognizes and helps fight infectious agents and other foreign substances that invade the body
	Antibody				A Y-shaped protein on the surface of B cells that is secreted into the blood or lymph in response to an antigenic stimulus, such as a bacterium, virus, parasite, or transplanted organ, and that neutralizes the antigen by binding specifically to it
	Anticoagulant				A medication that prevents or restricts the clotting of blood
	Antimicrobial Prophylaxis
	Approaches	Pict.
AD	Arc Deposited
	(Acetabular) arc of cover
	Arthralgia				Pain in a joint, usually due to arthritis or arthropathy
AHG	Arthritic hip grade
	Arthritis				Inflammation of the joint
	Arthrocentesis				The aspiration of synovial fluid from a joint, commonly the knee, for the purpose of diagnosing joint disease or removing fluid from joint to decrease pain. It may also be used to instill medication into a joint. Synovial fluid is normally a clear, light, straw-colored fluid. There are usually only small amounts of synovial fluid present in a joint. However, in certain diseases, such as rheumatoid arthritis or septic arthritis, the synovial fluid becomes cloudy and increases in volume as a result of inflammation and possibly infection in the joint. Bacteria and increased WBCs and protein may also be found in the synovial fluid of an inflamed or infected joint
	Arthrodesis				Arthrodesis is a surgical procedure that causes bone in a joint to grow solidly together, also known as joint fusion. The goal of arthrodesis is to provide pain relief, restore skeletal stability, and improve alignment in people with advanced arthritis
	Arthrogram				An x-ray to view bone structures following an injection of a contrast fluid into a joint area. When the fluid leaks into an area that it does not belong, disease or injury may be considered, as a leak would provide evidence of a tear, opening, or blockage	It is typically used to diagnose traumatic ligament and joint capsule injuries, most commonly of the shoulder or knee. An arthrogram involves the injection of air or a contrast agent into the joint capsule to provide an outline of the joint cavity and soft tissue structures. A local anesthetic will be used to minimize any discomfort from the injection. It is important that the injection into the joint be made using aseptic technique to prevent introduction of microorganisms into the joint. After injection of the air or contrast media, a series of x-rays are taken of the joint while it is put through the normal range of motion
	Arthroplasty				Another name for total joint replacement or joint reconstruction, a procedure in which a damaged joint is surgically reconstructed or removed and replaced with an artificial prosthesis. It is the treatment of choice for osteonecrosis when the joint is destroyed
	Arthroscope		Artroskop		A tube about 6 millimeters in diameter, that contains an optical system to look into the joints, lenses, light system, and fiber optic together. The system is coupled to a TV screen
	Arthroscopic Surgery		Artroskopisk kirurgi		A fairly common procedure in which the surgeon inserts a tiny, lighted instrument (fiberoptic scope containing a camera) into a small incision near a joint. This instrument projects an image onto a screen that allows the surgeon to see inside the joint. He or she is then able to make needed repairs or removed damaged tissue
	Arthroscopy		Artroskopi		A minimally-invasive or key-hole diagnostic and treatment procedure using X-ray guidance or a small, lighted, optic tube which is inserted into the joint through a small incision. Images of the inside of the joint are projected onto a screen. Small instruments inserted through the incision in the skin are used to perform the surgery. Arthroscopy minimizes surgical trauma with essentially no blood loss	The hip joint lies deep, large nerves and arteries pass close to it, the joint capsule is strong. There are risks for higher doses of X-rays and a transient nerve palsy
	Articular Debridement
ASR	Articular Surface Replacement				The brand name given to the hip resurfacing (metal-on metal) implant from Depuy that was taken from the market in 2010 due to many reports of pain and during investigation found higher than normal wear and loosened components	Produced in sizes 39 to 63mm in 2mm increments. Dysplasia and oversized cups were not made.
	Articulate surface				See "Lunate surface"
AL	Aseptic Loosening (of a prosthesis)		Aseptisk lossning (av en protes)		The loosening of a prosthesis without the involvement of bacteria
ALVAL	Aseptic Lymphocytic Vasculitis and Associated Lesions				Delayed chronic inflammatory response apparently due to metal sensitivity which may lead to revision of the implants	The term describes characteristic histological features seen in tissue obtained from metal-on-metal arthroplasties, for example revised for groin pain
	Aseptic necrosis		Aseptisk nekros		See AVN
	Asnis screw
	Aspiration
ARCO	Association Research Circulation Osseous (Classification Stages)	Pict.
	Atrophic
	Atrophy				The wasting of muscle, characterized by decrease in circumference and flabby appearance and resulting in decrease in function and muscle tone	Prolonged disuse, contracture, immobilization, muscle denervation
	Austin-Moore Prosthesis				A metallic unipolar femoral prosthesis used in hip hemiarthroplasties. It was one of the earliest prosthetic devices. Femoral prostheses are sometimes referred to as Moore or Austin-Moore prostheses
ASERNIPS	Australian Safety and Efficacy Register of New Interventional Procedures-Surgical
	Autogenous bone graft				When the bone for the graft is taking from the patient's own body. In hip and knee replacement surgery this kind of graft is hardly ever used since the amount of tissue required is too much. Most grafts in joint replacement surgery are of the “allograft” type	At the time of surgery a separate incision can be made to take a small piece of bone from an area of the body where it is not needed. Typically, autogenous bone grafts are taken from the pelvis or iliac crest. Autogenous bone grafting has excellent fusion rates and has become the standard by which all other biologics are measured. Many surgeons prefer autogenous bone grafts because there is no risk of the body rejecting the graft since it came from the patient's own body
	Autograft				See: Autogenous bone graft
	Autoimmune Disease				Any of a large group of diseases characterized by abnormal functioning of the immune system that causes your immune system to produce antibodies against your own tissues
	Autologous blood transfusion				Collection and reinfusion of a patient's own blood or blood components. An increased awareness of diseases transmitted by allogeneic blood has resulted in a dramatic increase in autologous blood transfusion. Clinical research and practice in autologous blood use have also grown in recent years, providing new insights into the issues involved. Despite reduction of the risk of transmitting viruses such as the human immunodeficiency virus (HIV) or hepatitis B or C (HCV),2,3 autologous blood transfusion remains safer than allogeneic blood transfusion and appropriate for properly selected patients. Exclusive or supplemental use of autologous blood can eliminate or reduce many adverse effects of transfusion. Directed donations (blood donated by a friend or family member for a designated patient) are not as safe as the patient's own blood and must not be considered equivalent to autologous donations
ACI	Autologous chondrocyte implantation			.
	Autotransfusion					Used when: 1-The patient is expected to lose sufficient blood during the perioperative period so as to require a red blood cell transfusion, and autotransfusion will likely reduce or eliminate the need for donor blood, 2-Religious beliefs cause the patient to refuse donor blood, but to accept autologous blood, 3-Compatible donor blood is not available, 4-The patient cannot donate sufficient quantities of autologous blood prior to surgery to satisfy the anticipated transfusion requirement, 5-The patient or physician prefers perioperative autotransfusion to pre-operative autologous donation or transfusion of donor blood
AVN	Avascular necrosis				Loss of bone caused by insufficient blood supply. Loss of blood supply can occur for many reasons such as steroid or heavy alcohol use and exposure to certain chemicals. In many cases, the cause of avascular necrosis will not be known. In the hip joint, it leads to progressive collapse of the femoral head (the ball of the hip joint), and secondary arthritic changes. in the knee, avascular necrosis is less common. It is also known as aseptic necrosis, ischemic necrosis and osteonecrosis
	Avascular necrosis of the femoral head				See AVN, but specifically applying the femur head	OK for Hip Resufacing if remaining bone stock is still adequate
	Avulsion				Avulsion is tearing away or forcible separation. Avulsion injuries are common in road traffic accidents. These injuries tear away ligaments causing joint dislocation and internal and external bleeding leading to formation of hematomas
	Avulsion fracture of lesser or greater trochanter				A bone fracture at the lesser or greater trochanter, tearing either trochanter away from the femur as a result of physical trauma. This can occur under direct external forces or pulling of tendons due to muscular contractions that are stronger than the forces holding the bone together
	Avulsion fracture or progressive radiolucency of lesser trochanter				A spontaneous rupture of the ilio-psoas tendon (for example a few days) after a Hip Arthroplasty with subsequent progressive radiolucency of the lesser trochanter
	Basicervical Fracture				An extracapsular two–part fracture, with the fracture plane running along the line of capsular insertion, just proximal to the lesser and greater trochanter.	It is usually misdiagnosed as either a femoral neck fracture or a trochanteric fracture. It should be classified and treated as a trochanteric fracture
	Benign bone				Bone tissue being of no danger to health; not recurrent or progressive; not malignant
PAO	(Bernese) PeriAcetabular Osteotomy				A hip joint preserving procedure performed to correct (reorientate) the acetabular articular surface in patients with congenital acetabular dysplasia. It was first performed in 1984 in Bern, Switzerland by Professor Reinhold Ganz with the assistance of Jeffrey Mast, after extensive feasibility studies in an anatomy lab including injection studies of the blood supply of the periacetabular bone	Dissatisfaction with available techniques led to this new procedure with its power of correction and intracapsular access, avoiding the danger of avascular necrosis. It should not interfere with the natural birth canal. The approach was chosen to produce little morbidity and reduced care in the postoperative period. The procedure uses a Smith–Peterson approach and evolved to one of the most frequently executed reorientations today, but the execution is technically rather demanding. Addressing the tendency to produce acetabular retroversion and an eventually insufficient head–neck offset has helped to avoid impingement after reorientation and has further improved the results
	BHR Dysplasia cup	Pict.			A special BHR (Birmingham Hip Resufacing) cup in the acetabulum, fixed with two screws, also used with the newer BMHR
	Bilateral				On both sides
	Bionik				A hip resurfacing prosthesis from the company ESKA that has an additional bearing insert and some other features like three prongs in the femoral head and a very thin femoral cap that sets it apart from usual resurfacing protheses.
	Bipolar prosthesis				A two component prosthesis used for hemiarthroplasties in which one prosthetic component is fixed rigidly in place on one side of the joint and the second component with which the first articulates is inserted loosely on the other side of the joint. The prosthesis is named after the fixed component. Motion of the across the joint component puts less stress on bone and the articulating surfaces. As an example, one design of a femoral bipolar hemiarthroplasty consists of a prosthetic femoral head articulating with a polyethylene liner in the acetabular component. The liner is inside a metal shell and can move with respect to the shell. The shell is press fitted into the acetabulum either with or without reaming of the acetabulum. The shell can move within the acetabulum. It is important when reading x-rays of bipolar implants to be aware that the across the joint component is mobile and not to interpret a change in position of this component as necessarily indicative of loosening
	Birmingham Hip				As supplied by Midland Medical Technologies
BHR	Birmingham Hip Resurfacing	Pict.	< earlier model shown	The acetabular cup of the latest version has a number of vanes in rear surface, preventing it from roatation in the period when bone ingrowth has not completed yet	The hip resurfacing device marketed by Smith & Nephew that Mr. Derek Mc Minn and other UK surgeons developed from earlier less successfull resurfacing devices. The present BHR has the longest track record, has served the largest number of hip patients and so far the highest success rate of the 15 resurfacing devices marketed today	The acetabular cup is a cementless device, whereas the femoral cap is cemented. The cup is a hemispherical design with a cast-in porous ingrowth surface called Porocast, consisting of small beads. Dysplasia and oversized cups are also available
BMHR	Birmingham Mid-Head Resectioning Prosthesis	Pict.		The standard BMHR heads are of metal but a ceramic head (coated?) version is available on special order. Thereby the following material combinations exist: standard MOM, COM or COC	Derek Mc Minn's newest BMHR, now having a straight shaft, where the earlier type had a bend. The BMHR preserves the distal part of the femoral head and neck and does not invade the medullary canal of the femur. It is useful in young patients with severe hip arthritis in the presence of poor quality femoral head bone because of osteonecrosis or cystic degeneration or those with unfavorable proximal femoral anatomy including patients with post-Perthes disease and slipped capital femoral epiphysis	The Birmingham Mid-Head Resection device is a cementless proximal load-bearing device. The full range of BHR cups, including dysplasia and oversized cups can be used with the BMHR
	Blood Clot	Pict.
BMI	Body Mass Index	Pict.			An estimate of body composition correlating a person's weight and height to lean body mass. The BMI is an index of weight adjusted for stature. It is calculated by dividing weight in kg. by height (in m. but squared). High values can indicate excessive fat stores, while low values can indicate reduced fat stores	At BMI greater than 30kg/m2 patients may no longer be considered good candidates for the hip resurfacing procedure. This will have to be considered individually as always with candidature with hip resurfacing
	Bone allograft				A bone graft performed with donated human bone	There is concern about the possible introduction of HIV or hepatitis B or C through the donated bone
	Bone attrition				Bone on bone contact
	Bone densitometry				See DXA and DEXA
	Bone Derivative				A substance extracted from bone. A common bone derivative is bone morphogenic proteins (BMP) which the body uses to induce bone formation. The substance has been shown to stimulate new bone formation in certain sites, and is used in certain types of fusion surgery	Bone morphogenic protein products are in various stages of development and use with the goals of growing better bone and supplanting the use of autograft bone in bone grafting procedures
BFR	Bone Formation Rate
BGF	Bone graft				The transplantation of healthy bone from one part of the body to replace injured or diseased bone in another part of the body	A hole from a cyst in the femoral head is sometimes filled with scrapings from milling of the femoral head
	Bone marrow		Benmärg		A soft, fatty network of connective tissue that fills the medulla, the internal cavity of bones. Marrow contains stem cells that produce the three cellular components of blood: platelets, leukocytes and red blood cells. The tissue also contains osteoprogenitor cells that help in the formation and growth of new bone	Bone marrow can be combined with bone graft substitutes in lumbar spine fusion surgery with the goal of enhancing the probability of attaining a successful spinal fusion
BME	Bone Marrow Edema				See: "BMES"
BMES	Bone Marrow Edema Syndrome				A "bone bruising" phenomenon previously undetected on conventional radiographic techniques but seen on MRI. It is recognised as focal signal abnormalities in subchondral bone marrow and the appearances are thought to represent microtrabecular fractures, haemorrhage and oedema without disruption of adjacent cortices or articular cartilage	Bone marrow edema syndromes, even without history of trauma are increasingly recognised, particularly in the hip joint and knee. It was initially assumed to be a precursor of osteonecrosis, but scientific evidence is conflicting, at present they are best considered closely related diseases with overlapping clinical and radiological presentations. Most recently, the presence and persistence of marrow edema patterns in early osteoarthritis are showing promise as a potential marker of actively progressive disease
BMP	Bone Marrow Pressure
	Bone metastases				The spread of malignant cancer cells to bone
BMAD	Bone Mineral Apparent Density
BMC	Bone Mineral Content
BMD	Bone Mineral Density				Measures the mineral density (such as calcium) in bones using Dual Energy X-ray Absorptiometry, Quantitative Computed Tomography scan, or ultrasound. From this information, an estimate of the bone strength and fracture risk can be made
BMP	Bone Morphogenetic Protein				Bone morphogenetic proteins, BMPs, are a group of endogenous proteins that may be used to stimulate growth of bone damaged by osteonecrosis. They are extracted from the body and synthesized through genetic engineering	Recombinant human bone morphogenetic protein two, rhBMP-2, is the only FDA approved BMP for human use. It is used with bone grafts and spinal cages for interbody fusion of vertebral bodies
	Bone resection				Removal of the articular ends of one or both bones forming a joint
	Bone resorption				the process by which osteoclasts break down bone and release the minerals, resulting in a transfer of calcium from bone fluid to the blood. The osteoclasts are multi-nucleated cells that contain numerous mitochondria and lysosomes. These are the cells responsible for the resorption of bone. Attachment of the osteoclast to the osteon begins the process. The osteoclast then induces an infolding of its cell membrane and secretes collagenase and other enzymes important in the resorption process. High levels of calcium, magnesium, phosphate and products of collagen will be released into the extracellular fluid as the osteoclasts tunnel into the mineralized bone. During childhood, bone formation exceeds resorption, but as the aging process occurs, resorption exceeds formation	Calcium-sensing membrane receptors in the parathyroid gland monitor calcium levels in the extracellular fluid. Low levels of calcium stimulates the release of Parathyroid hormone (PTH) from chief cells of the parathyroid gland. PTH stimulates active resorption of calcium in the thick ascending limb and distal convoluted tubule in the kidney. PTH also increases the number and activity of osteoclasts to release calcium from bone, and upregulates the enzyme 1-alpha-hydroxylase present in kidney cells, which increases the production of Vitamin D. Vitamin D, in turn, increases the amount of calcium absorption from the small intestine. The net result is to increase levels of calcium in the blood
	Bone scan				A test called technetium-99m bone scanning, used in patients who have normal x rays and no risk factors for osteonecrosis. In the test, a harmless radioactive material is injected through an intravenous line, and a picture of the bone taken with a special camera. The picture shows how the injected material travels through blood vessels in bone. A single bone scan finds all areas in the body that are affected, thus reducing the need to expose the patient to more radiation	This test detects areas of increased or decreased bone metabolism (turnover). The test is performed to identify abnormal processes involving the bone such as tumor, infection, or fracture
	Bone spurs				Abnormal projections of bone, also known as osteophytes.  Usually caused by increased stress or wear on the ends of bones
	Brooker Classification	Pict.
	Buck Cement Restrictor				A plug that is placed down in the femoral canal to stop the used cement from going further down
	Bursa				Fluid-filled sac located between a bone and a tendon or muscle. Bursa sacs are normal and allow smooth gliding of the tendons and ligaments during normal movement of the joints. In disease processes such as arthritis, the bursa sacs located close to the joint may become inflamed and painful
	Bursitis				Bursitis is inflammation of the bursa. Bursas (bur’sah) (Latin-purse) are closed sacs lined with membrane containing fluid. They are found or formed in the areas of friction. These structures are also prone to infection causing bursitis, which may also be a cause of chronic joint pain and swelling
	Calcar femorale				The calcar femorale is a spur of thick bone that lies deep to the lesser trochanter but posterior to the neutral axis of the femoral neck. It is thickest medially where it joins the compression buttress of the neck and gradually thins as it passes laterally. X-rays taken at right angles to the neutral axis of the femoral neck show the calcar femorale, standing out like a solid bone spur
CW	Calcar width	Pict.
	Calcification				Hardening of tissue
CT	Calcitonin				Calcitonin is a hormone secreted by the thyroid gland that lowers the levels of calcium and phosphate in the blood. It primarily metabolizes blood calcium by decreasing calcium absorption by the intestines, increasing calcium storage in bones and increasing calcium excretion through the kidney	Calcitonin also improves bone strength by inhibiting the resorption of bone by osteoclasts. Because of its analegesic (pain relieving) effects, it is in medication form often prescribed for patients with osteoporosis and vertebral fractures caused by osteoporosis
	Calcium pyrophosphate deposition disease				See 'Pseudogout'
CBR	Canal Bone Ratio			Used in cases with osteoporosis	The ratio between the endosteal and outer diameters of the proximal femur at 10 cm below the lesser trochanter	by Yeung et al
CCR	Canal-Calcar Ratio	Pict.
CFI	Canal Flare Index
	Cancellous bone				Cancellous bone is the meshwork of spongy tissue (trabeculae) of mature adult bone typically found at the core of vertebral bones in the spine and the ends of the long bones such as the femur. The structure of the cancellous bone can be likened to a honeycomb that consists of interconnecting spaces containing the bone marrow	The marrow of cancellous bone tissue supplies osteoprogenitor cells that help in the formation and growth of new bone. Thus, bone grafts composed of cancellous bone are sometimes used in grafting procedures to promote osteogenesis
	Cancellous screw				A screw designed for placement in cancellous bone. The pullout strength of a screw is proportional to the amount of metal-bone contact. Because cancellous bone is porous, threads for cancellous bone screws have to be longer than for cortical screws to achieve the same degree of metal-bone contact and thus have the same pullout strength as cortical screws
	Cannulated cancellous screw	Pict.			Cannulated cancellous screws (from titanium or stainless steel) are used for metaphyseal fractures, they have a hollow central shaft. The main advantage of cannulated screws is that they can be inserted over a guide (Kirscher) wire or guide pin. With the very small guide pin diameter it can be accurately placed using fluoroscopy in the operating room. In addition, given its small diameter, the guide pin can be reinserted several times if necessary for accurate placement without excessive damage to bone	Cannulated screws can be self-tapping or non self-tapping. There is a chance that the screw perforates the joint if placed in a bone with their tips close to the subchondral bone
	Capsule				The strong, fibrous, flexible sac that surrounds the hip joint and contains the sinovial membrane.  The sinovial membrane produces sinovial fluid, a liquid that lubricates the joint
	Capsulotomy
	Caput femoris				The femoral head
CFRPBT	Carbon Fibre Reinforced PolyButyleneTerephthalate
	Cartilage				Cartilage is a type of dense, blueish or greyish tissue like substance that is hard in consistency. Cartilage is composed of cells called as Chondrocytes. These cells are dispersed in a gel like matrix. Cartilage is not supplied by blood vessels but is kept alive by the nutrients diffusing through the matrix. Cartilage is found in joints, nose, ear, throat, the space between each vertebra and even in the rib cage. Cartilages have a very good nerve supply which makes any injury to them very painful.There are three main types of cartilage: hyaline, elastic and fibrocartilage. Cartilage usually covers the articulating surfaces of the joints. In the hip they are found covering the head of the femur bone and the cavity that holds the head in the pelvis	The tissue cells are embedded in a compact matrix of cavities (lacunae) enabling the cartilage to bear pressure and tension. Wear and tear on cartilage can cause it to degenerate. This degeneration is often referred to as osteoarthritis
	Catheter				Hollow tube used for passing into various organs for drainage or administering treatments
	Caudal				Towards the back or tail
	Cautery device				The device with which burning, searing, cutting, or scarring of tissue can be accomplished. These electical devices exist for different operating temperatures and thier tips can normally be exchanged
	Cell Saving				See: "ICSM"
	Cement penetration				The amount that cement can penetrate in bone	Research shows that the pressure applied while the cement is still liquid influences the penetration depth. Another point of importance is the dryness and cleanliness of the bone prior to the application / pressurization of the cement
	Central-inferior				Below the central part of….
CVP	Central Venous Pressure
CEA	Centre-Edge Angle	Pict.			See: "Lateral Center-Edge Angle (of Wiberg)"
	Ceramic				The challenge today in internal prosthetics is to develop materials that are stronger and more durable and much tolerable by the human body. The use of ceramic in hip prosthesis has a lot of research into it. The alternatives to traditional polyethylene materials used in total hip replacement arthoplasty include cross-linked polyethylene components and hard-on-hard bearings including metal-on-metal and alumina-on-alumina ceramic. When comparing hard-on-hard bearings, the ceramic-on-ceramic coupling has many theoretical advantages. Ceramic has extremely low coefficient of friction and a high potential for wear resistance and less debris, this translates into an artificial joint that is more close to the normal hip
CoC	Ceramic-on-Ceramic				A replacement joint in which both parts, or both surfaces, are ceramic
CoM	Ceramic-on-Metal				A replacement joint with a metal cup and ceramic head	This is a less common combination of materials but it is suggested to produce less metal ions than with metal-on metal joints
	Ceramic-on-plastic				A replacement joint in which one part or surface is ceramic (usually the ball or head) and one part or surface is plastic (usually the socket)
	Cerclage wire
	Cerebral palsy				A group of non-progressive neurological physical disabilities in the development of human movement and posture. Secondary orthopaedic deformities are common, for example hip dislocation, slipped capital femoral epiphysis and scoliosis of the spine	High rate of dislocations are reported in connection with cerebral palsy
	Chamfer Reamer	Pict.
	Chana Reamer Handle	Pict.			Mr. G.Chana patented an offset reamer handle that allows better view over the reamed acetabulum in MIS hip resurfacing operations
	Charnley initial incision retractor
	Chiari (pelvic) osteotomy	Pict.			With Chiari osteotomy, the pelvis is osteotomized just above the origin of the hip joint capsule. The inferior segment of the pelvis is then displaced medially, resulting in increased femoral head coverage. Capsule is interposed between the femoral head and the proximal shelf of bone. This capsular tissue undergoes metaplasia into fibrocartilage	The Chiari osteotomy is considered a "salvage  procedure"
	Chondroblasts				Immature cartilage-producing cells
	Chondrocalcinosis				See 'Pseudogout'
	Chondroplasty				Surgery of cartilage in a joint. This can be performed the conventional way or by means of arthroplasty	In the surgical technique a damaged joint's surface can be cut, scraped, lasered or burred away in the hope that the healthy joint surface will heal over the defect
	Chondroprotective Agents				Products like glucosamine and chondroitin sulfate work by easing osteoarthritis pain, restoring cartilage, repairing damaged joints and renewing synovial fluid
	Chronic Pain				Any pain that lasts for more than three months. The pain can become progressively worse and reoccur intermittently, outlasting the usual healing process. After injured tissue heals, pain is expected to stop once the underlying cause is treated, according to conventional ideas of pain. However, chronic pain can persist after injuries heal for no apparent biological cause	The most common sources of chronic pain include low back pain, headache and arthritic pain. Chronic pain can cause significant psychological and emotional trauma and often limits an individual’s ability to fully function
CRI	Chronic Renal Insufficiency				When a disease such as IgA nephropathy slowly and gradually destroys the filtering capacity of the kidneys. It is sometimes referred to as progressive renal insufficiency, chronic kidney disease or chronic renal failure (CRF). This kind of damage cannot currently be repaired, and as such, it is irreversible. A person may have chronic renal failure for many years, even decades, before dialysis or a kidney transplant become necessary. Chronic renal insufficiency does not, by itself, mean complete shutdown of the kidneys, and a person with chronic renal insufficiency may still pass urine normally, and may have more than enough kidney function left for normal functioning of the body
	Circumflex artery				The artery that encircles the base of the femoral neck, also supplying the arteries submerging into the femoral head	The branching arteries around the femoral head can be damaged during chamfering operations on the head. This can later lead to femoral neck fracture or loosening of the replacment shell
	Clearance				A good fit between the head and the socket for a perfect positioning of the implant
	Clinical efficacy				The effectiveness of clinical therapy or procedure judged in terms of its benefit to the patient
	Clinical Trial				A scientific research study typically designed to test the safety and effectiveness of a new drug, device or treatment on humans. A clinical trial is conducted with voluntary patients who qualify according to set inclusion/exclusion criteria which are usually based on age, gender, type or stage of disease, treatment history and other medical conditions. Participants in clinical trials can potentially gain access to new treatments before they are available to the public and obtain expert medical care. However, many trials are “randomized”, which means that participants are randomly assigned to receive either the new treatment or the control group (e.g. current standard of care or placebo) treatment, so not all participants will receive the drug or device being studied	Participants run the risk of serious or life-threatening side effects to any new treatment. In the United Statues, clinical trials are conducted under the direction of the Food and Drug Administration (FDA) before being made available for general clinical use in healthcare
CSO	Clinically Significant Organism
	Closed Reduction				Fracture repair done without surgery
	Closing Wedge Osteotomy				The attempt to transfer the forces of the body weight onto the normal, non-arthritic side, by actually changing the angulation of either the tibia or the femur bone. The 'closing wedge method is done by cutting out a wedge and letting the gap collapse. Plates and screws are used to keep the bones together and lined up. See also 'Opening Wedge Osteotomy"
CNS	coagulase-negative staphylococci
CNS	Coagulase-Negative Staphylococcus
	Cobalt and Chromium Ions
CoCr	Cobalt Chrome				Cobalt-Chrome is found in many surgical implants then often as cobalt-chromium-molybdenum alloy. The alloy has been a preferred material for implant surgeries, particularly total hip replacement, because it is tolerated well by the body. In the spine, cobalt chrome is used with some artificial disc replacement devices but otherwise has had limited usefulness	Can inhibit bone growth according to some. It is not very MRI compatible and imaging can be problematic
	Cobb Elevator
	Cognitive Restructuring				Cognitive restructuring is a psychotherapeutic technique that emphasizes restructuring thought processes into less stressful terms. Individuals learn how to recognize maladaptive beliefs in stress-producing situations and then modify their unhealthy thought patterns in an effort to reduce stress and related physical ailments	Cognitive restructuring can be used to treat patients with many types of chronic pain based on the idea that reversing negative thoughts and emotions towards the problem will help the individual alleviate the pain symptoms internally
	Collum femoris				The femoral neck
	Comminuted fracture				A break or splinter of the bone into more than two fragments. Since considerable force and energy is required to fragment bone, fractures of this degree occur after high-impact trauma such as in vehicular accidents	External fixation devices such as splints and casts are usually inadequate in treating this type of fracture. Repairing a comminuted fracture often requires open surgery to restructure the bone to normal anatomy
	Common Femoral Artery
CBC	Complete Blood Count
CCS	Composite Clinical Success
	Compound Fracture				In addition to the characteristics of a displaced fracture, in this case, the ends of a broken bone pierce the skin. In addition to severe pain, there is some bleeding
CHS	Compression Hip Screw
CTA	Computed Tomography Angiography				A computed tomography technique used to visualize arterial and venous vessels throughout the body, ranging from arteries serving the brain to those bringing blood to the lungs, kidneys, arms and legs
CAD	Computer Aided Diagnosis					Aims to support radiologists in analyzing medical data with respect to pathologies
CAOS-UK	Computer Aided Orthopaedic Surgery - UK				The Society for Computer Assisted Orthopaedic Surgery in the UK
CAOS	Computer Assisted Orthopaedic Surgery				This is the International Society for Computer Assisted Orthopaedic Surgery		www.caos-international.org
CAS	Computer Assisted Surgery				Is also known as image-guided surgery, surgical navigation, and 3-D computer surgery and applies to any computer-based procedure that uses technologies such as 3D imaging and real-time sensing in the planning, execution and follow-up of surgical procedures. CAS allows for better visualization and targeting of sites as well as improved diagnostic capabilities, giving it a significant advantage over conventional techniques
CAT scan	Computerized Axial Tomography				A diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays
	Concomitant hip dislocation
	Concomitant Pelvic Osteotomy
	Congenital				Inborn or existing at birth
	Congenital dislocatable hip					The hip is in place at birth, but dislocates fully when stressed
CDH	Congenital Dysplasia of the Hip				A condition of abnormal development of the hip, resulting in hip joint instability and potential dislocation of the thigh bone from the socket in the pelvis. This condition has been more recently termed developmental hip dysplasia, as it often develops over the first few weeks, months, or years of life	See also: "dysplasia" and "CHD"
	Congenital hip dislocation				Dislocation of the hip in newborns
CHD	Congenital Hip Dysplasia				See "CDH"
	Congenital subluxatable hip				An inborn or existing incomplete or partial dislocation of the hip joint	The hip is in place, but dislocates partially when stressed
C+	Conserve® Plus	Pict.			Wright Medical Technology's resurfacing implant	Available in sizes from 36-54mm in 2mm increments, no oversize or dyplasia cups avialable
CPR	Contact Patch to Rim distance
CPM	Continuous Positive Motion Machine				A machine that applies gentle continuous range of motion to a joint. Even when the patient is at rest
	Contracture				The resistance to movement of muscle or joint as result of fibrosis or supporting soft tissues	Shortening of muscle or ligament structure, tightness of soft tissue, immobilization, incorrect positioning
	Controlled hypotension				To diminish the bleeding from the slack, open blood vessels during a general anesthesia, the anesthesiologist may lower the blood pressure.	Shortening of muscle or ligament structure, tightness of soft tissue, immobilization, incorrect positioning
	Contusion				a bruise caused by a blow to the muscle, tendon, or ligament; caused when blood pools around the injury and discolors the skin
	Conventional Total Hip Disadvantage				More loss of healthy bone
	Conventional Total Hip Disadvantage				Cannot cross legs while sitting on a chair
	Conventional Total Hip Disadvantage				Cannot safely indulge in sporting activities
	Conventional Total Hip Disadvantage				Cannot squat or sit on the floor without the risk of dislocating the hip
	Conventional Total Hip Disadvantage				Decreased amount of bone marrow and loss of arteries supplying the top of the femur with blood
	Conventional Total Hip Disadvantage				Feels less like a normal natural hip
	Conventional Total Hip Disadvantage				Increased risk of dislocation
	Conventional Total Hip Disadvantage				Larger incission required
	Conventional Total Hip Disadvantage				Longer recovery period and physiotherapy
	Conventional Total Hip Disadvantage				Possibility of changed foot direction after surgery
	Conventional Total Hip Disadvantage				Possibility of changed leg length after surgery
	Conventional Total Hip Disadvantage				Range of movement more limited
	Conventional Total Hip Disadvantage				Revision Surgery difficult
	Conventional Total Hip Disadvantage				Risk of prosthesis loosening in the femur
	Conventional Total Hip Disadvantage				The arteries of the femoral head and neck are removed with the sawn off neck
	Conventional Total Hip Disadvantage				The femur's marrow is partly or some times completely removed
	Conventional Total Hip Disadvantage				The natural loading and stimulation of the femur's bone is lost by the removal of the neck and introduction of a more wedge-like prosthesis
	Core decompression	Pict.			A surgical procedure somtimes applied with ON or AVN in which the inner layer of the bone is removed to reduce pressure within the bone, thereby increasing blood flow to the bone. In people with early osteonecrosis, the procedure may reduce pain and slow the progression of bone and joint destruction. In another approach 3-4mm holes are drilled in the dead bone and bony substitutes (any of many kinds with different properties) inserted
	Cormet 2000				A hip resurfacing implant from Corin Medical
C2K	Cormet 2000				Corin's two-part resurfacing implant. The "2000" is now no longer used by Corin.
	Cortical bone				The dense outer surface of bone that forms a protective layer around the internal cavity. This type of bone also known as compact bone makes up nearly 80% of skeletal mass and is imperative to body structure and weight bearing because of its high resistance to bending and torsion	Cortical bone in the spine, arms and legs can be damaged by trauma or bone disease such as osteoporosis. To treat weakened cortical bone, grafting can be employed using synthetic bone material and other surgical implants like metal plates, screws and wires to reinforce the weakened areas
CI	Cortical Thickness Index	Pict.
CHI	Corticosteroid hip injection
	Corticosteroids				Any of the steroid anti-inflammatory hormones produced by the adrenal cortex or their synthetic equivalent, such as cortisol or aldosterone or Prednisone.	One of the side-effects of Prednisone therapy is avascular necrosis
COI	Cost-Of-Illness				a comprehensive methodology to assess the scale and nature of infections as a health problem and raise the profile of the patient group who suffer from them	Through identification of the three basic components of the burden, i.e. the direct costs, the costs due to loss of productivity (indirect costs) and the psychosocial or intangible costs, the COI studies may assist the decision-making process at policy and planning levels, and reveal where the major burden of cost might lie in the treatment and care of these patients
	Cotyloid fossa
	Coumadin				Anticoagulant used to prevent the formation of blood clots. The generic name for Coumadin is Warfarin. This drug thins the blood and decreases the risk of blood clots after surgery
	COX-2 inhibitor				A relatively new class of non-steroidal anti-inflammatory drugs (NSAID’s) that targets the COX-2 enzyme specifically. These COX-2 inhibitors work by limiting the formation of inflammation, which is a common component of many forms of back pain and types of chronic pain. The main advantage of the drug over traditional NSAID’s is that it inhibits the specific enzyme associated with inflammation, fever and pain without disrupting the enzyme associated with the integrity of the stomach lining and maintenance of platelet and kidney functions	COX-2 inhibitors can be used in treating chronic pain-related inflammation with a minimal risk of gastrointestinal complications. COX-2 inhibitors do have their own unique potential risks and complications and are available only be prescription
	Coxa plana				Flattening of the head of the femur resulting from osteochondrosis of its epiphysis
	Coxa profunda				With the condition coxa profunda the acetabular fossa is too deep and its medial aspect overlaps with the ilioischial line on radiographs. Coxa profunda is commonly associated with femoroacetabular impingement	Coxa profunda can cause increased stress on the inner (medial) section of the acetabulum. This results in painful motion and eventual degeneration of the hip. Early arthritis is common.
	Coxa saltans			The condition is usually curable with appropriate treatment and may even heal spontaneously. If it is painless, there is little cause for concern. Correcting any contributing biomechanical abnormalities and stretching tightened muscles, such as the iliopsoas muscle or iliotibial band, is the goal of treatment to prevent recurrence.	Coxa saltans is also called: "snapping hip,  iliopsoas tendinitis, or dancer's hip". Two forms are known: 1: the more common "lateral extra articular coxa saltans" and 2: the less common "medial extra-articular coxa saltans"	1: This occurs when the iliotibial band, tensor fascia lata, or gluteus medius tendon slides back and forth across the greater trochanter. This normal action becomes a snapping hip syndrome when one of these connective tissue bands thickens and catches with motion. The underlying bursa may also become inflamed, causing a painful external snapping hip syndrome. 2: The iliopsoas tendon catches on the anterior inferior iliac spine (AIIS), the lesser trochanter, or the iliopectineal ridge during hip extension, as the tendon moves from an anterior lateral (front, side) to a posterior medial (back, middle) position. With overuse, the resultant friction may eventually cause painful symptoms, resulting in muscle trauma, bursitis, or inflammation in the area.
	Coxa valga				A deformity of the hip, whereby the angle between the ball and the shaft of the femur is greater than 135 degrees	Coxa valga can also be called a 'Valgus hip'. A normal angle would have been between 120 -135 degrees
	Coxa vara				A deformity of the hip, whereby the angle between the ball and the shaft of the femur is less than 120 degrees. This results in the leg being shortened, and therefore a limp occurs. It is commonly caused by injury, such as a fracture. It can also occur when the bone tissue in the neck of the femur is softer than normal, meaning it bends under the weight of the body. This may either be congenital, also known as Mau-Nilsonne Syndrome, or the result of a bone disorder	Coxa vara can also be called a 'Varus hip'. A normal angle would have been between 120 -135 degrees
	Crepitation				The crackling sound or grating sensation as result of friction between bones	Fracture, chronic inflammation, dislocation
	(John F.) Crowe scale with DDH				The Crow scale is used to indicate the severity in Developmental Hip Displasia cases by classifying the degree of femoral head migration in relation to the true acetabulum like follows: 1: hips have less than 50% subluxation; 2: hips have between 50% to 75% subluxation; 3: hips have between 75% to 100% subluxation; 4: hips have complete dislocation
	Crystal deposition disease				See 'Pseudogout'
	Curved Hohmann elevator
	Cutoff guide	Pict.
	Cutoff saw	Pict.
	Cylindrical reamer	Pict.
	Cyst (in bone)				A solitary fluid-filled cavity in a bone, usually in the shaft of a long bone, especially the humerus, in a child. The cyst can cause pain in or near it. Also called a unicameral bone cyst or solitary bone cyst.	Cysts of more than 2 cm in diameter in the femoral head or in the acetabulum minimize the chance on a resurfacing implant, but sugeons do have different opinions to what is allowable or not. This is one reason why a resurfacing should be performed at the earliest possible opportunity.
	Dancer's hip				See: "Coxa saltans"
	Debridement				A medical treatment or surgical procedure to remove damaged, de-vitalized, dead or infected tissue and other unwanted material from a wound to promote healing with remaining healthy tissue	For some infected-hard healing wounds the maggot debridement therapy (MDT) is sometimes used
	Deep Femoral Artery
DVT	Deep Venous Thrombosis				After hip or knee surgery, the risk of blood clots in a deep vein (a vein that accompanies an artery), usually in a lower leg, thigh or pelvis increases. Obesity, higher age, diabetes, certain genetic profiles, inactivity, trauma, burns and orthopaedic procedures increase this risk. If you have had a blood clot in the past, an increased risk of a clot after a surgical procedure in the future exists. Compression boots, early exercise and mobility of the patient, minimizing the surgical trauma, and anticoagulant drugs reduce the risks. Most clots can be "silent" and occur without any obvious signs. The clot can break off and go to the lungs, causing breathing difficulties, or even death. New and unexpected swelling of the leg, calf pain, cough, chest pain, or difficult breathing after surgery can be indicative of a blood clot. With any suspicion of a clot a deep venous ultrasound which is a non-invasive test designed to detect clots can be used. If a deep clot is found in the leg, an anticoagulant drug must be continued for several months. By then the clot should be re-absorbed by the body and no longer breake off and travel to the lungs. While the body is eliminating the clot, the anticoagulant drug ensures that the clot does not grow further	This kind of thrombosis can occur after surgery and may cause redness, pain and swelling
	Degeneration				Degeneration literally means sinking from a higher level to a lower one. Medically degeneration is defined as a regressive change in the cells and tissues of a particular part as a consequence of which the functions may be inhibited or destroyed. In a fracture of the hip bone for example the affected individual is unable to use his huge bulk of leg muscles causing them to loose their function, they slowly degenerate, this is why you need physiotherapy or rehabilitation techniques to enable you to stop this degeneration. Degeneration may also occur after an operation to replace the diseased joint, hence it is absolutely necessary to do the necessary exercises and workouts to prevent degeneration
	Degenerative Arthritis				A condition that involves the chronic breakdown of cartilage in the joints leading to painful joint inflammation. In the spine, facet joint osteoarthritis, sometimes called degenerative arthritis or spinal arthritis, causes a breakdown of cartilage between the facet joints in the back of the spine. When the joints articulate, the lack of cartilage causes pain as well as limits on motion. The condition is more common in adults over the age of 60	Degenerative arthritis can be successfully treated using one or a combination of non-surgical treatments, such as water therapy, exercise, pain medications, and chiropractic manipulation in order to maintain motion in the back. Rarely surgery will be required to alleviate the pain
DJD	Degenerative Joint Disease				A condition that causes the loss of cartilage and bone in a hip joint that eventually leads to increased hip joint pain and reduced hip joint function	Also called "Osteoarthritis"
dGEMRC	delayed Gadolinium-Enhanced MR of Cartilage
	DeLee & Charnley zones	Pict.			Radiolucency appearing in any or all of the three "DeLee & Charnley" zones determines the degree of loosening for an acetabular cup
	Demineralized Bone				Bone that has had the calcium removed and is used to make bone tissue more conducive to spinal fusion. Bone morphogenic proteins from demineralized bone are added to a polymer or glycerol substrate to form a product that enhances bone growth. The product lacks enough osteoinductive property that it cannot be used on its own. Instead, demineralized bone is added to enhance a bone graft increasing the rate of fusion
DBM	Demineralized Bone Matrix
DFDBA	Demineralized Freeze-Dried Bone Allograft
DFDBA	Demineralized freeze-dried bone allograft
	DePuy ASR				DePuy's Articular Surface Replacement	One of the Hip Resurfacing implants available
	Derotational Osteotomy				In this procedure the femur is cut and rotated to match up with the acetabulum better and prevent the femoral head from slipping out of the acetabulum
DDH	Developmental Dysplasia of the Hip				Developmental dysplasia of the hip is a congenital (present at birth) condition of the hip joint. It occurs once in every 1,000 live births. The hip joint is created as a ball and socket joint. In DDH, the hip socket may be shallow, letting the "ball" of the long leg bone, also known as the femoral head, slip in and out of the socket. The "ball" may move partially or completely out of the hip socket	Reflects the fact that there are cases with apparently normal hips at birth, but develop the problem in the first year of life
DRG	Diagnosis-Related Group
	Dial Osteotomy	Pict.			In this procedure the complete acetabulum is cut free from the pelvis and then moved into the most ideal position and allowed to heal
	Diaphyseal fracture
DCM	DICOM medical imaging file format				A file format that is used in medical imaging like CT-scans, X-rays, MRIs and ultrasouns, enabling transport by networks and by e-mail	Patients may upon request be given a CD with the DCM files and a dedicated viewer.
DISH	Diffuse Idiopathic Skeletal Hyperostosis				A bone-forming disorder that at first sight resembles DJD or osteoarthritis but can form osteophytes without sclerosis or joint narrowing
DICOM	Digital Imaging and Communications in Medicine				An imaging and communication system designed for medical purposes	The so-called *.dcm file format is derrived from the DICOM system
DVF	Digital Video Fluoroscopy
	Diplegia				Diplegia is the loss of function and sensation of corresponding parts on both sides of the body. Diplegia may occur because of the paralysis of nerves passing from the spinal column to the corresponding limbs. Diplegia causes wasting of the muscles of the limb making them degenerate without any excitatory impulses from the nerves
	Dislocation				Term used to describe the displacement of an organ or any other part. Dislocation specifically means a disturbance or disarrangement of the normal relation of the bones in the formation of a joint. Dislocation weakens the ligaments and thus the joint may become loose and dislocate repeatedly. Hence it is necessary to set right a dislocated joint as soon as possible
DRI	Dislocation Resistance Index
	Displaced Fracture				A more serious fracture in which the bone breaks into two or more pieces, and is knocked out of alignment. Patients typically notice disfigurement and experience sharp pain. Tendons and ligaments are sometimes torn or severely stretched
	Distal				Structures that are more distant from the point of attachment in the body
DLRS	Distal Locked Revision Stem
	Disuse osteoporosis				The form of osteoporosis that may occur due to disuse of a bone. For example after an amputation or due to stress shielding in a bone that received a stiff prosthesis. The cortex of the bone under investigation with x-ray can appear mottled and irregular due to cortical holes
	Dorsal				Indicating the relative position of a finding to the rear of or posterior of a structure under investigation
	Double shell (or cup) athroplasty
Dr	Dr. Derek McMinn				One of the world’s leading hip surgeons pioneering the Hip Resurfacing procedure
Dr	Dr. Koen De Smet				With a record of over 3500 BHRs and 3800 THRs
	Drug abuse	Pict.			That drug abuse can weaken the skeleton is shown by the picture on the left
DEXA	Dual Energy X-ray Absorptiometry				A technique used to accurately measure a patient's bone density. To measure it the subject is lying on a couch for 5-10 minutes while an x-ray gantry passes over the area to be assessed like the lower spine and hip or sometimes the forearm
DXL	Dual X-ray and Laser				Combines a dual-wavelength X-ray source with laser definition of the measurement area. The result is that soft tissue and fatty tissue are excluded from the bone mineralization reading, resulting in extremely accurate measurements of the bone density		http://www.demetech.se/code/solutions.htm
	DUROM	Pict.			The resurfacing implant from the company Zimmer in Switzerland
	DVT prophylaxis				Preventive measures against occurance of Deep Venous Thrombosis
	Dynamic compression				The compression of a fracture by weight bearing and/or muscle contraction. Fracture fixations that employ dynamic compression include dynamic hip screws, anti-glide plates, dynamized tibial and femoral nails, and tension band wiring
DHS	Dynamic Hip Screw	Pict.
	Dysplasia				An abnormality in the appearance of cells due to disturbances in the cell maturation process. This is indicative of an early step towards transformation into a neoplasia	See also: "Congenital dysplasia of the hip"
	EBI Bone Healing System
EBF	Ectopic bone formation				Abnormal bone formation in the soft tissues around the operated hip. This occurs in more than one third of all patients in the months after hip replacement surgery
	Edge loading	Pict.			The incorrect loading and consequent wear of the edge of the acetabular cup, through an incorrect placement of the cup (high cup inclination and/or excess anteversion of the cup and femoral neck)	The so-called "runaway wear" that is caused can be seen using scanning electron microscopy
	Effusions				The escape of fluids from the blood vessels or lymphatics into the tissues or a cavity, possebly with swelling and pain	Trauma, especially to knee
	Electric cautery				The burning, searing, cutting, or scarring of tissue by an electircal instrument
	Electrocoagulation
EMG	Electromyogram				An electromyogram measures the electrical activity of skeletal muscles. It involves inserting small gauge electrode needles into the skeletal muscle and providing a mild electrical stimulus to the muscle. The resulting electrical activity of the muscles is recorded	An electromyogram is used to evaluate muscle weakness or pain and to differentiate between neurological and muscular disorders. The EMG is most commonly used to detect primary muscle disease or lower motor neuron disorders
	Electrosurgical pencil				A small pencil like instrument used in surgery for cutting and coagulating, by means of a high frequency current.	Depending on the pencil it may have several functions and accept exchangeable tips/electrodes. The functions and control of the pencil is for some models by regulated by incoporated buttons while other models may use footpedal control.
	Embolism				Embolism is the obstruction or occlusion of a vessel by a transported clot, gas, a mass of bacteria or by any other foreign material
	Ender nail				Also referred to as an Ender rod. A smooth, flexible rod used for intramedullary fixation of long bone fractures. The nail is used for diaphyseal fractures in patients whose epiphyseal growth plates are still open. It is inserted through the metadiaphyseal region, avoiding the epiphyseal plate so that the growth of the bone is not impaired
	Endoprosthesis
	Endorphins				The natural painkillers produced by the body. The protein molecules bind to receptors in the brain and spinal cord to stop messages of pain and create an analgesic effect. In the treatment of back pain, electrical stimulation has been shown to promote the release of endorphins. Likewise, aerobic exercise for a prolonged period of time is thought to increase the production of endorphins	The release of endorphins probably creates the "runner’s high" that occurs during exercise
	Endoscopy				The use of a telescopic viewing device inserted into a body cavity via a small incision together with specialised surgical tools, enabling the surgeon to see the inside of the body cavity on a television screen and identify and repair the defect
EG	Eosinophilic Granuloma				Eosinophilic granuloma is the benign form of the 3 clinical variants of Langerhans cell histiocytosis, which include Letterer-Siwe disease, Hand-Schüller-Christian disease, and EG (formerly termed histiocytosis X). EG is characterized by single or multiple skeletal lesions, predominantly affecting children, adolescents, or young adults
EDA	Epidural Anaesthesia				Anaesthesia given on (or outside) the dura mater through a tiny catheter. There are several anatomical layers that cover the spinal cord. The space just above the cord and the cerebral spinal fluid is called the subarachnoid or subdural space. The area adjacent or above this is the epidural space. Epidural anaesthesia is placed in contact with the dura, but not entering it. Here the anaesthetic substance may move up the spinal cord and affect the respiration	One of the key advantages of epidural anaesthesia is that it helps to minimize the pain you initially experience after surgery
	Epiphyseal dysplasia
	Epiphysis				The end of a bone where it meets another bone or bones to form a joint
ESR	Erythrocyte Sedimentation Rate				This 1-hour test measures the distance (in millimeters) that red blood cells settle in unclotted blood toward the bottom of a specially marked test tube. It can be used to monitor inflammatory or malignant disease. It is useful in detecting and monitoring tuberculosis, tissue necrosis (death), rheumatologic disorders, or an otherwise unsuspected disease in which symptoms are vague or physical findings are minimal
	Etiology				See: "Aetiology"
	Etiopathology				See: "Aetiopathology"
EMEA	European Medicines Agency				European Agency for the approval of medicinal products (including prosthesis)
	Exostosis	Pict.			A benign bony growth projecting outward from any bone surface in the body. Depending on it's location it can be capped by cartilage	See also: Multiple Hereditary Exostoses (MHE)
EKA	Expositionaquivalente fur Krebserzeugende Arbeitsstoffe
ETO	Extended Trochanteric Osteotomy
FVL	Factor V Leiden				An inherited disorder of blood clotting (not a disease!). Factor V Leiden is the name of a specific mutation that results in thrombophilia, or an increased tendency to form abnormal blood clots in blood vessels. People who have the factor V Leiden mutation are at somewhat higher than average risk for a type of clot that forms in veins, such as the deep veins of the legs (deep venous thrombosis), or a clot that travels through the bloodstream and lodges in the lungs (pulmonary embolism)
FP	False Profile				The False Profile view used in x-ray examination and when taken with a foot position that delivers a pelvic rotation value of 65 degrees can show important details of the complete hip joint
FPR	False Profile Radiograph				A reliable and cheap technique to evaluate the anterolateral parts of the femoral head, and the acetabulum, as suggested by Lequesne
	False Profile X-ray				See: "False Profile radiograph" from Lequesne
	Fascia lata
FES	Fat Embolism Syndrome				Fat Embolism Syndrome is a potentially fatal complication of fractures. It most commonly occurs in patients who have experienced a fracture of the femur, tibia, pelvis, or multiple fractures. It usually develops within the first 24–48 hours after injury	After a fracture, it is theorized that fat globules are released from the bone marrow, entering the patient’s bloodstream, where the emboli travel to the lungs and become lodged in pulmonary capillaries. Another theory is that catecholamines are released due to the trauma, leading to an alteration in lipid stability that results in the development of fat globules that enter the bloodstream
FP	Faux Profile				Other name for oblique view, as used in radiography	In standing position, the FP view provides better means to measure the joint space narrowing in the hip joint
	Felon				Abscess occurring in pulp space (tissue mass) of distal phalanx of finger as a result of infection	Minor hand injury, puncture wound, laceration
FAN	Femoral Antegrade Nail				A long intramedullary nail type that can be used with differing and multiple femoral fractures	Also see: "AFN"
	Femoral artery
FW	Femoral canal width	Pict.
	Femoral condyles	Pict.			The large flared prominences on the distal end of the femur, identified as lateral and medial femoral condyles. They are covered with a thick layer of hyaline cartilage and articulate with the patella and the tibia at the knee joint
	Femoral Head				The top of the femur bone, also known as the ball of the hip. It rotates inside the "acetabulum" in the pelvis.
	Femoral Head Migration	Pict.			The changed position of the femoral head in relation to the acetabulum due to a condition, disorder or disease
	Femoral head notching				The scraping or cutting into the bone of the femoral neck, usually from cylindrical reamers or other instruments used during the surgery by a surgeon unaware of the consequences that will follow	The main causes for femoral neck fractures are superior and inferior femoral neck notching during preparation and varus positioning of the femoral component. Other factors include simple overload with gross osteoporosis, osteonecrosis (especially at the junction of viable and non-viable bone), prosthetic design, large trochanteric osteotomy, and stress riser effect of screw holes or drill holes used for trochanteric osteotomy
FHOC	Femoral Head Ossification Center
FHRA	Femoral Head Resurfacing Arthroplasty
	Femoral Neck Arteries	Pict.			The artery structure on the femroal neck that supplies the femoral head with blood
	Femoral Neck Fracture				A fracture of the hip, whereby the neck of the thigh bone (femur) is partially or completely broken
	Femoral osteotomy				A surgical procedure whereby the femur (thigh bone) is cut in the higher region and the bone angled differently in an attempt to improve the mechanics of the leg and or hip joint
FAI	Femoro-Acetabular Impingement				Can occur when intrinsically normal intra-articular soft tissue structures are exposed to joint loading forces that physically exceed their tolerance level posing these pathomorphologies as precursors of osteoarthritis	The damage from FAI can occur to the articular- or the labral cartilage. Three types of FAI are recognized: CAM, Pincer and Mixed
	Femur				The upper leg, or thigh bone	The end of the femur "femoral neck" meets with the pelvis in the acetabulum
	Fibromyalgia				A fairly common chronic syndrome characterized by scattered musculoskeletal pain (involving the muscles and bone structure), tenderness in specific areas, and generalized fatigue. Most common in relatively young, otherwise healthy-appearing individuals, it occurs much more often in women than in men	The condition is associated with aching and stiffness in areas around the neck, shoulders, upper back, lower back and hip areas, and may occur alone or in conjunction with rheumatic disorders such as arthritis, osteoarthritis, or lupus
	Fibrous dysplasia				Fibrous dysplasia is a disease of the bone in which the outer layers of the bone become thin, and the inner bone marrow is replaced by a gritty fibrous tissue containing sharp, needle-like fragments of bone
	Fibrous stroma
FGIA	Fluoroscopically Guided Intra-Articular Injection
	Fovea capitis				The central roughened pit on the hemispherical head of the femur where also the ligament of the head of the femur is attached	The fovea capitis can sometimes be mistaken for erosion of the joint surface on radiographs
	Frameless Stereotaxy				Real-time localization of surgical instrumentation in corresponding images of the patient
FDBA	Freeze-Dried Bone Allograft
FWB	Full Weight Bearing
	Gadolinimum - arthrogram MRI
	Gait				The pattern, way or manner in moving on foot. Walking and running are the two basic human gaits. With hip and knee arthritis, the gait pattern is altered, leading to a limp. Typically, the patient will subconsciously put less weight on the arthritic joint, leading to an abnormal gait
	Ganglion				Small, fluid-filled synovial cyst usually on dorsal surface of wrist and foot	Degeneration of connective tissue close to tendons and joints leading to formation of small cysts
	Ganz osteotomy
	Garden screw
	Gaucher’s disease				A congenital disease in which there is accumulation of fatty compounds in the liver, spleen, lymph nodes, and nervous system. Having the disease has been associated with the development of osteonecrosis	high rate of hip prosteses loosening reported
	General anaesthesia				A state of total unconsciousness resulting from general anaesthetic drugs	The general anaesthetic is administered in either the operating theatre itself or a special ante-room. General anaesthesia can be induced by intravenous (IV) injection, or breathing a volatile anaesthetic through a facemask (inhalational induction). Onset of anaesthesia is faster with IV injection than with inhalation, taking about 10-20 seconds to induce total unconsciousness. This has the advantage of avoiding the excitatory phase of anaesthesia (see below), and thus reduces complications related to induction of anaesthesia. An inhalational induction may be chosen by the anaesthetist where IV access is difficult to obtain, where difficulty maintaining the airway is anticipated, or due to patient preference (eg. children). Commonly used IV induction agents include propofol, sodium thiopental, etomidate, and ketamine. The most commonly-used agent for inhalational induction is sevoflurane because it causes less irritation than other inhaled gases
	Girdlestone				Complete arthrodesis of the hip following failure of a prosthesis	This is a complete fusion of the hip, following failed prostheses
	Gluteus Maximus				A large muscle that covers the rear hip, also sometimes known as the ‘butt muscle.’  This is a superficial muscle that is cut through and pulled back to access the bones of the hip during hip replacement surgery
	Gluteus Medius				A broad Muscle located near the gluteus maximus. About 1/3 of this muscle lies under the gluteus maximus. The lower edge of the medius is near the piriformis muscle.  Both the gluteus medius and the piriformis are attached to the greater trochanter and this flap of muscles must be pulled back during hip replacement surgery in order to access the bones of the hip
	Gluteus Minimus				A small muscle that occurs just below portions of the gluteus maximus.  The gluteus minimus is attached to the greater trochanter and is part of the flap of muscles that must be pulled back during hip replacement surgery in order to access the bones of the hip
	Gout				A painful rheumatic disease. It results from deposits of needle-like crystals of uric acid in the connective tissue, joint spaces, or both. These deposits lead to inflammatory arthritis, which causes swelling, redness, heat, pain, and stiffness in the joints. The term Arthritis is often used to refer to more than 100 different rheumatic diseases that affect the joints, muscles, and bones, and may also affect other connective tissues. Gout accounts for about 5 percent of all cases of arthritis
GFAAS	Grafite Furnace Atomic Absorption Spectrometry				Chromium serum ion concentrations of a patient with a metal-on-metal implant can be analyzed using GFAAS	Specific instructions have to be followed to prevent changes of the taken samples during storage and transport to the test lab. This is due to possible contamination, depletion and reactions with the syringe, tube or container's materials
GNB	Gram-negative bacilli
	Greater Trochanter				A large projection on the end of the femur and away from the hip joint. A number of muscles are attached on the femur at this location
	Groin lateral projection				See: "Magilligan projection"
GMFCS	Gross Motor Function Classification System
GH	Growth Hormone
	Gruen zones	Pict.			Radiolucency appearing in any or all of the seven "Gruen" zones determines the degree of loosening for a THR shaft in a femur
	Guide pin
	Guide wire
Hgb	Haemoglobin				Haemoglobin is the iron-containing oxygen-transport metalloprotein in the red cells of the blood in mammals and other animals. Hemoglobin in vertebrates transports oxygen from the lungs to the rest of the body, such as to the muscles, where it releases the oxygen load. Hemoglobin also has a variety of other gas-transport and effect-modulation duties, which vary from species to species, and which in invertebrates may be quite diverse
	Haptics				Feedback of sensory information, whether proprioceptive, vestibular, kinesthetic, or tactile, to the user from the simulated environment
	Hardinge (modified Hardinge)				An indirect lateral approach, whereby a curvilear split is made through the anterior portion of the gluteus medius and vatus muscles	This approach to the hip can cause damage to the superior gluteal nerve, as research has shown
HHS	Harris Hip Score				A tool for the evaluation of patients after a hip replacing operation. Based on a total of 100 points possible, each question is awarded a certain number of points based on how it is answered
	Head Impactor
HMO	Health Maintenance Organization				A "managed care" health insurance system in the U.S. where referrals are screened by a PCP, and specialists are limited to those in the HMO network of providers
HICPAC	Healthcare Infection Control Practices Advisory Committee
HRQL	Health-Related Quality of Life
	Hematoma				Hematoma as the name suggests, is not a tumor but a localized collection of blood outside a blood vessel, contained within an organ or tissue. The blood is usually in a clotted (solidified) state. The color and consistency of a hematoma depends on the time after the leakage of blood into that tissue
	Hemi- surface replacement	Pict.			A procedure whereby the surgeon only replaces the worn or damaged surface of the femoral head, leaving the natural acetabulum (hip socket) intact	A hemi-surface replacement can be recommended for patients who have osteonecrosis of the femoral head and have enough remaining articular cartilage on the acetabulum or pelvic side. The method preserves and maintains bone by providing physiological stress transfer to the femoral neck and proximal femur. The disadvantage is the rapid wear of the cartilage and the new operation needed to place a matching acetabular cup	A page with information and a table on different resurfacing options and makes
HA	Hemi-Arthroplasty	Pict.			Replacement of one side of a joint with a prosthesis. The prosthesis in a hemiarthoplasty can have a unipolar or bipolar design. In a unipolar design, the prosthetic component is on only on side of the joint. In a bipolar design, there is a prosthetic component on the other side of the joint that is not fixed in place. In a total hip arthroplasty, the across the joint component is rigidly fixed in place	Hemi-arthroplasty is often recommended for patients who have osteonecrosis of the femoral head and have enough remaining articular cartilage on the acetabulum or pelvic side. The method preserves and maintains bone by providing physiological stress transfer to the femoral neck and proximal femur. The disadvantage is the rapid wear of the cartilage and the new operation needed to place a matching acetabular cup	A page with information and a table on different resurfacing options and makes
	Hemophilia				This inherited disorder of blood is manifested by an increased tendency to bleed. It causes a defect in the body’s mechanism to control bleeding, even if it is due to trivial injury. There are two types hemophilia, namely A and B. Some of the manifestations are: Bleeding that doesn’t stop within a few minutes of infliction, Hemearthrosis or bleeding into a joint cavity producing painful hot swollen joints and muscle hematomas in the calf
	Hemosiderin deposition				Hemosiderin or haemosiderin is an abnormal microscopic pigment found in the human body. Hemosiderin is composed of iron oxide and can accumulate in different organs in various diseases. Iron is required by many of the chemical reactions in the body but is toxic when not properly contained. Thus, many methods of iron storage have developed
HIT	Heparin-Induced Thrombocytopenia				Heparin-induced lowering of the platelet count in a patients blood
HO	Heterotopic ossification			See: Brooker classification	The formation of unwanted lamellar bone within soft tissue structures outside the skeletal structure. HO can form into a mature bone structure with cortex and medullary cavity containing bone marrow cells and variable amount of hematopoiesis. The exact mechanism by which such a process begins and evolves is not clearly understood but various hypotheses are proposed. Formation of heterotopic bone is known to be associated with some predisposing etiologies such as neurogenic, traumatic, genetic and some surgical procedures. Because HO most commonly involves the large joints, significant morbidity and functional deficit may result regardless of the primary etiology. Established lesions of HO which interfere with function, ambulation or posture, predispose to pressure sores, or cause intractable pain are amenable to surgical resection. Surgical resection of heterotopic bone results in significant improvement of functional state of the patients	Another explanation: the process by which trabecular bone forms outside of the skeletal structure, occupying space in soft tissue where it does not normally exist. This misplaced growth occurs between muscle planes and not within the muscle fibers themselves. Furthermore, though the new bone often abuts existing skeletal structure, it does not interfere with the configuration of the periosteum
HESW	High-energy Extracorporeal Shock Waves
	Hilgenreiner's line	Pict.			The line drawn on the AP pelvis radiograph between the two Y-shaped triradiate cartilages of both acetabulii. A perpendicular line is then drawn down the anteriorinferior iliac spine. Normally the femoral epiphysis should lie in the lower inner quadrant. If there is developmental hip dysplasia the femoral epiphysis will lie in the superolateral quadrant
	Hip approaches	Pict.			To reach the hip different approaches exist, each with advantages abd disadvantages over the others, see the picture for some of them
	Hip labral tear				A tear in the cartilage that forms a rim around the socket portion of the hip joint
HRA	Hip resurfacing arthroplasty				The surgery that replaces the damaged outer surface of the femoral head found at the top of the thighbone and, if necessary, the cup-shaped socket where the thighbone meets the pelvis in the hip joint. This was done in the 1970s, but it's use decreased because the new joint surfaces did not hold up well
	Hip Resurfacing contraindication				A BMI greater than 30kg/m2
	Hip Resurfacing contraindication				Active infection and AIDS
	Hip Resurfacing contraindication				Bone cyst larger than 1cm
	Hip Resurfacing contraindication				Decompensated renal insufficiency
	Hip Resurfacing contraindication				Insufficient acetabular or femoral bone stock
	Hip Resurfacing contraindication				Known allergy to one of the constituents of the implant
	Hip Resurfacing contraindication				Leg length deficiency greater than 3cm
	Hip Resurfacing contraindication				Malignant tumours
	hip spacer				A temporary prosthesis like device that can be fitted when a THR revision operation is done in two stages, commonly for the treatment of infections	It misses an acetabular cup but with it's large head it gives the patient some mobility (using two crutches) for the short time between the operations. The spacer is usually made of PMMA and comes coated in an antibiotic. Some have articulating heads
HSR	Hip Surface Replacement
	Histiocytic infiltrate				That Infiltrates the human immune system
	Hohmann Elevator
	Hohmann Retractor
HIP	Hot Isostatic Pressing				A method sometimes used to improve the cast of resufacing components. The structure's alloy gets a more uniform crystal size and is freed of voids and impurities
hBMP	human Bone Morphogenetic Protein
	Hunter's canal
HA	Hyaluronic acid				Hyaluronic acid is a glycosaminoglycan (GAG), that attaches to collagen and elastin. Some of the hyaluronic acid products available: naturally occurring hyaluronan (Hyalgan) and synthetic hylan G-F 20 (Synvisc). Hylans are cross-linked hyaluronic acids, which gives them a higher molecular weight and increased elastoviscous properties. The higher molecular weight of hylan may make it more efficacious than hyaluronic acid because of its enhanced elastoviscous properties and its longer period of residence in the joint space (slower resorption)	The exact mechanism of action of viscosupplementation is unclear. Although restoration of the elastoviscous properties of synovial fluid seems to be the most logical explanation, other mechanisms must exist. The actual period that the injected hyaluronic acid product stays within the joint space is on the order of hours to days, but the time of clinical efficacy is often on the order of months. Other postulated mechanisms to explain the long-lasting effect of viscosupplementation include possible anti-inflammatory and antinociceptive properties, or stimulation of in vivo hyaluronic acid synthesis by the exogenously injected hyaluronic acid
HAP	Hydroxyapatite				Hydroxyapatite (Ca10(PO4)6(OH)2) is a calcium phosphate mineral contained in normal bone and teeth and therefore called an "osteoconductive" material. The lattice-like structure of hydroxyapatite crystals accounts for the rigidity of bones. Hydroxyapatite is often used in the manufacture of bone void filler products that provide scaffolding for bone growth to supplement a patient’s own bone in orthopedic procedures	Used as coating, usually plasma-sprayed. If hydroxyapatite crystals become embedded in or around joints, it may result in a painful inflammatory condition known as hydroxyapatite crystal disease
	hydroxyapatite crystal disease				The inflammation caused by hydroxyapatite crystals
	hydroxyapatite crystals				Hydroxyapatite molecules can group together (crystalize) to form microscopic clumps, called hydroxyapatite crystals
	Hyperparathyroid Hormone				A drug, sold under the brand name Forteo.It is claimed to stop bone loss and also stimulate new bone formation
	Hyperplastic synovium
	Hypertrophic
	Hypertrophy				The increase in size of muscle as result of enlargement of existing cells	Exercise, increased androgens, increased stimulation or use
HS	Hypovolemic Shock				Since bone is very vascular, a fracture can lead to internal or external hemorrhage. Hypovolemic shock can develop if the patient loses large quantities of blood immediately following a fracture	Shock is more likely to occur if the fracture involves the thorax, pelvis, spine, or extremities, especially the femur
	Iatrogenic				Refers to the adverse physical or mental condition which is caused by an operation, a treatment or diagnostic procedure by medical personnel.	This applies to
	Idiopathic				Idiopathic denotes a disease of an unknown cause. For example, most people with avascular necrosis have no identifiable cause. In them, the disease is idiopathic
	Iliopsoas tendinitis				See: "Coxa saltans"
	Iliotibial Band				A tendinous extension of the fascia covering the gluteus maximus and tensor fascia latae muscles proximally. It descends distally to attach to the lateral condyle of the tibia. It also sends fibers to the lateral aspect of the patella (knee cap). Essentially, the ITB is the linkage between the pelvis, upper leg, and lower leg
IEF	Ilizarov External Fixator
IGS	Image Guided Surgery					See also: CAS and 3-D Computer Surgery
ICLH	Imperial College/London Hospital				The so-called ICLH doublecup surface hip replacements were earlier attempts with hip resurfacing components of different materials but bad results
CI	Indexed cardiac output
ICP-MS	Inductively Coupled Plasma Mass Spectrometry				Cobalt and titanium serum ion concentrations in the blood of a patient with a metal-on-metal implant can be analyzed using ICP-MS, through venous blood sampling	Specific instructions have to be followed to prevent changes of the taken samples during storage and transport to the test lab. This is due to possible contamination, depletion and reactions with the syringe, tube or container's materials
	Infectious arthritis				An infection in the joint fluid and tissues
	Inferior				Below or under
	Inferior gemellus
	Inflammation				A fundamental pathologic process, consisting of a dynamic change in the action of cells in the affected blood vessels and tissues, caused by a physical chemical biological agent. The main signs of inflammation are redness, pain, warmth and swelling accompanied with or without loss of function
	Inflammatory arthritis				A condition that can include Rheumatoid rrthritis, Ankylosing spondylitis and Systemic lupus erythematosus	OK for Hip Resurfacing if bone quality is adequate
IJD	Inflammatory Joint Disease
IBG	Injectable Bone Graft				A biocomposite product that can be injected into otherwise hard to reach places. The composite product is resorbable
ISS	Injury Severity Score
	Insufflation				The use of carbon dioxide to inflate body cavities during endoscopic surgery to enable surgeons to view internal organs
IGF	Insulin-like Growth Factor
	interference fit				See "Press fit"
IMN	Intramedullary Nailing
	Internal Fixation				The use of surgical pins or rods and screws to stabilize a bone while healing from a fracture
	Internal obturator
INR	International Normalized Ratio				See: PT
	Intertrochanteric crest
	Intertrochanteric Fracture				A fracture occuring below the hip about 3-4 inches from the joint
ITO	InterTrochanteric Osteotomy				The intertrochanteric osteotomy is seen in the following forms: flexion, varus,  valgus, rotational and extension. They are applied for differing reasons and using differing fixation methods, most internal some external
IASHI	Intra-Articular Steroid Hip Injection
	Intra-Capsular				Everything within the capsule. For example, the femoral neck is an intra-capsular part of the femur
	Intramedullary Canal or Medullary Canal				The canal that runs up the center of the femur.  The prosthetic stem is placed in this canal as part of hip replacement surgery
IMN	Intramedullary nail(ing)				A nail used in the intramedullary canal which extends along the middle of a long bone like the femur or tibia is a common treatment with fractures of the same bones
IM	IntraMuscularly
ICSM	Intraoperative Cell Salvage Machine				An intraoperative cell salvage machine suctions, washes, and filters blood so it can be given back to the patient's body instead of being thrown away and requiring blood transfusion	An advantage of this technique is the patient receives his/her own blood instead of donor blood, so there is no risk of contracting outside diseases. Because the blood is recirculated, there is no limit to the amount of blood that can be given back to the patient. The cell saver is also a viable alternative for patients objecting to blood transfusions from religious convictions
IMP	Intra-operatively Manufactured Prosthesis				A method applied to THR
	Intraosseous
	Intrathecal anesthesia				Anesthesia is given within a sheath, within either the subarachnoid or the subdural sheath. Instillation of intrathecal medication is a newer technique but it is performed in much the same way as epidural anesthesia. A very small dose of an anesthetic is mixed with a local anesthetic and placed within the subdural sheath. The risks of overdosage and toxicity with local anesthetics are minimal because of the small dose necessary
	Intra-trochanteric fracture
	Invasive				The beginning or incursion of a disease is termed as invasive. The term usually refers to an infectious organism or cancer cells capable of metastasis
IDE	Investigational Device Exemption				FDA classification that allows the implanting of a device during a clinical trial
	Ischemic necrosis				See AVN
	Ischium
	Isotope scan					Can show some other activity than normal X-rays or MRI would be able too
	Jewett nail plate
	Joint mobilisation				Use of specific passive procedures to restore accessory movements, stretch joint capsules and ligaments and to reduce pain and muscle guarding of stiff joints
	Joint Space				The distance between the femoral head and the acetabulum, the average of the minimum and the maximum
JSN	Joint Space Narrowing
JCA	Juvenile Chronic Arthritis				Juvenile Chronic Arthritis defines a group of Systemic Inflammatory Disorders affecting children below the age of 16 years, with the following major subsets: 1-Pauciarticular onset, with 4 or less than 4 joints involved; 2-Polyarticular onset, with more than 4 joints involved and 3-Systemic onset, with fever, rash and arthritis	JCA or JRA affects girls more than boys. Unlike adult rheumatoid arthritis, which is chronic and lasts a lifetime, children often outgrow juvenile chronic or juvenile rheumatoid arthritis. However, the disease can affect bone development in the growing child
JRA	Juvenile Rheumatoid Arthritis				See "JCA".
	Juvenile Scoliosis				A condition (rather than a disease or diagnosis) of abnormal curvature of the spine in children 3 to 9 years of age. While scoliosis can be caused by congenital, developmental or degenerative problems, most cases actually have no known cause (idiopathic scoliosis). Scoliosis usually develops in the thoracic spine (upper back) or the thoracolumbar area of the spine, which is between the thoracic spine and lumbar spine (lower back)	It may also occur just in the lower back. The curvature of the spine from scoliosis may develop as a single sideways curve (shaped like the letter C) or as two sideways curves (shaped like the letter S)
	Kaplan-Meier analysis
	Kellgren and Lawrence scale				A radiological method used for the assessment or prediction osteoarthritis
	Kirschner wire				A thin smooth stainless steel pin with a drill tip. This wire, available in different diameters and with various tips is mainly used in orthopaedics and plastic surgery, especially during hand surgery. It can be used as a first guide for further larger guides and instruments	They can act as fixation devices for small bones, as guide wires for insertion of cannulated nails, and as accessory components with external fixation devices
	Knowles pin	Pict.			A special type of cannulated cancellous screw that is used for fixation of slipped capital femoral epiphysis in children	The smae pins are also used for some forms of fenorla neck fractures in younger patients
	K-wire				See "Kirschner wire"
	Kyphosis				Anteroposterior or forward bending of spine with (round back) convexity of curve in posterior direction; common at thoracic and sacral levels	Poor posture, tuberculosis, chronic arthritis, growth disturbance of vertebral epiphysis, osteoporosis
	Labrum				The cartilage that forms a rim around the socket portion of the joint
	Lag screw				A screw inserted across a fracture that provides compression to the fracture. Lag screws can provide static or dynamic compression. The term "lag" refers to the function of a screw. The physical design of the screw, the type of bone the screw is inserted into, and the manner in which it is inserted determine whether a screw functions as a lag screw. In the diaphyses of long bones, cortical screws are used as lag screws while cancellous screws function as lag screws for cancellous bone fractures
	Lap Sponge				A sterile gauze pad used to absorb blood and fluids or clean surgical areas during surgery
	Laparoscopy				Is also known as keyhole surgery, bandaid surgery, or minimally invasive surgery. It usually refers only to operations within the abdomen or pelvic cavity. Laparoscopic surgery belongs to the field of endoscopy
	Larsen scale				A system used for the grading of radiographs in Rheumatoid Arthritis
	Lateral				Near the sides or away from the body's midline
	Lateral approach				The term used by surgeons who do hip replacement surgery. It refers to the exact anatomic route the surgeon must take to reach the hip joint. The patient is placed on the side. Then, the skin is cut over the hip area. Next, a thick layer of tissue called the fascia lata is cut. Next, a heavy muscle which helps one walk is split, and the hip joint becomes visible. Once the joint is dislocated, the femoral head is in case of resurfacing machined and the femoral cap fitted. With a THR the femoral head is cut off, the bone reamed or filed and the artificial hip's shaft inserted. A variant of this procedure is the minimally invasive hip replacement, which is essentially the same operation, but performed with a smaller incision
LCEA	Lateral Center-Edge Angle (of Wiberg)	Pict.			Measures femoral head lateralization an AP view of pelvis. Angle formed by intersection of a vertical line through the center of the femoral head and a line extending through the center of the femoral head to the lateral sourcil. Normal: 25 - 45 degrees; <20 is diagnostic of DDH
	Lauenstein position				A specific position of a patient to x-ray the hip joint. The knee of the leg to be x-rayed is bent, and the thigh is drawn up to nearly a right angle, also called frog leg position
LLD	Leg Length Discrepancy				Differences between the lengths of upper and/or lower legs
	Leg Pain				Characterized by aches, numbness, tingling, burning, or weakness, leg pain quite often is not caused by a problem in the leg or foot, but rather by a condition in the lower back. In fact, with many low back problems, there is actually little or no low back pain. Compression or pressure on any of the nerve roots in the low back can cause pain, numbness or weakness along the different nerves as they travel down through the leg and into the foot	Because the sciatic nerve is commonly affected, leg pain and related symptoms are often generally referred to as sciatica, although medical professionals prefer the term radiculopathy
LCPD	Legg-Calvé-Perthes Disease	Pict.			A hip disorder that develops in childhood. The theory is that during childhood, for some unknown reason, the blood supply to the hip ball (femoral head) is lost. As a result, a part or all of the bone involved temporarily dies. The socket part of the hip (acetabulum) is fine, but the head intermittently loses its blood supply and goes through cycles of healing and injury. As a result, the head becomes deformed. Instead of the usual round shape of the hip ball, a patient with Perthes disease has a flattened and deformed hip ball on x-rays. Because of the incongruence between the flat head and the round socket, degeneration and arthritis can set in very quickly. These patients are typically referred for joint replacement surgery and the challenge is how to defer surgery as long as possible, since many patients with Perthes disease will develop hip arthritis early on in their lives	The name comes from the three men involved: Arthur T.Legg, Jaques Calvé and George C. Perhes
	Lesion (in bone)				An abnormality in a bone, usually found in one of the longer bones of the skeleton	A non-neoplastic form of a lesion is the general bone cyst. Other forms of lesions exist, between them malignant (cancerous) and benign (non-cancerous) forms
LTT	Leukocyte Transformation Testing
	Ligament				A ligament is a white, shiny, flexible band or a sheet of fibrous tissue that connects two or more bones or cartilage. Extra capsular ligaments are the structures that hold the bones of various joints together. They keep them just apart so as to achieve maximum mobility with minimum friction. Some ligaments are specifically designed to restrict movement. Capsular ligaments are part of the capsule surrounding a joint. Their main function is to reinforce the joint. Ligaments are slightly elastic under tension. That is why a dislocated joint must be rest quickly to prevent the ligaments becoming lax and causing future problems	Joints are held together by ligaments. With advanced arthritis, these ligaments can become torn and stretched. During a hip or knee replacement procedure, the supporting ligaments are usually preserved, and "balanced" by the surgeon to get as much mobility and stability back as possible. If necessary, special implants can be used that substitute for the damaged ligaments and provide stability to the joint
	Ligament of the Head of Femur				See: "Ligamentum capitis femoris"
LCF	Ligamentum capitis femoris	Pict.			Also called "Ligament of the Head of Femur". A triangular, somewhat flattened band implanted by its apex into the antero-superior part of the fovea capitis femoris. It's base is attached by two bands, one into either side of the acetabular notch, and between these bony attachments it blends with the transverse ligament. It is ensheathed by the synovial membrane, and varies greatly in strength in different subjects. The LCF increases the steadiness of the erect posture and unloads the muscle apparatus. This ligament also transmits the "obturator artery" to the femoral head	The ligament is made tense when the thigh is semiflexed and the limb then abducted or rotated outward; it is, on the other hand, relaxed when the limb is adducted
	Ligamentum teres femoris				see 'Ligamentum capitis femoris'
	Ligature of the femoral neck				Vasculature deprivation of the femoral neck
LWD	Linear Wear Depth
	Local anaesthesia				Any technique to render part of the body insensitive to pain without affecting consciousness	To achieve conduction anesthesia a local anesthetic is injected or applied to a body surface. The local anesthetic then diffuses into nerves where it inhibits the propagation of signals for pain, muscle contraction, regulation of blood circulation and other body functions. Relatively high drug doses or concentrations inhibit all qualities of sensation (pain, touch, temperature etc.) as well as muscle control. Lower doses or concentrations may selectively inhibit pain sensation with minimal effect on muscle power. Some techniques of pain therapy, such as walking epidurals for labor pain use this effect, termed differential block
LIA	Local Injection Analgesia
	Long guide pin and jig technique					As used in the Birmingham Hip Resurfacing procedure
LPW	Long Posterior Wall
	Lordosis				Deformity of spine resulting in anteroposterior curvature with concavity in posterior direction; common in lumbar spine	Secondary to other deformities of spine, muscular dystrophy, obesity, flexion contracture of hip, congenital dislocation of hip
LFA	low friction arthroplasty
LMWH	Low molecular weight heparin			Dalteparin, Enoxaparin, Nadroparin, Tinzaparin, Fondaparinux	One of the thromboprophylaxis methods, proven to be effective with total hip arthroplasty	Low molecular weight heparin should be avoided in patients with a prior history of HIT
	Lovenox				Anticoagulant used to prevent the formation of blood clots. This is a substitute for Coumadin. The disadvantage of using Lovenox over Coumadin is higher cost, and the need for the daily injections that the patient must self-administer. The advantage is that monitoring of the drug is not necessary
LEA	Lumbar Epidural Anaesthesia
	Lunate surface	Pict.
	Lupus				see: Systemic Lupus Erythematosus
	Luxation	Pict.	Hoppa ur led
	Lymphatics				Conduits that drain fluid and infection
	Magilligan projection				The groin lateral projection from Magilligan with the patient in supine position can be used in radiography of the hip joint	The FP view is a better method than the Magiligan projection to determine joint space narrowing
MRI	Magnetic Resonance Imaging				A radiology technique that uses magnetism, radio waves, and a computer to produce images of body structures. The MRI scanner is a tube surrounded by a giant circular magnet. The patient is placed on a moveable bed which is inserted into the magnet. The magnet creates a strong magnetic field which aligns the protons of hydrogen atoms, which are then exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal that is detected by the receiver portion of the MRI scanner. The receiver information is processed by a computer, and an image is then produced	Bone is better imaged by conventional x-rays in some cases and CT is preferred for patients with severe bleeding. MRI may not always distinguish between tumor tissue and edema fluid and does not detect calcium when this is present within a tumor. In most cases the examination is safe for patients with metal implants, with the exception of a few types of implants, so patients should inform the technician of an implant prior to the test
MRT	Magnetic Resonance Tomography		Magnetresonanstomografi
	Magnetic Therapy				A form of alternative medicine using magnetic fields to treat medical conditions. Permanent magnets are placed close to the body in order to cause bones to heal faster, relieve pain and induce other therapeutic effects. It is most commonly recommended by practitioners as a cure for joint disorders and back problems	Critics charge that no evidence shows that magnet therapy has any real benefits, and thus relegate it to the realm of pseudo-science. It may act as a placebo in some people
	Malignant bone				Bone tissue that is threatening to life; such as in a malignant disease and has the potential and tendency to metastasize
MACS	Manual Ability Classification System
	Marrow				Bones are not completely solid. Some bones like the long bones of the arms and the legs have cavities in them to make them light. This cavity is filled with a soft fatty substance called the marrow. These sites, being highly nutritious, are a favorite site for infection by pyogenic organisms. They destroy the joint, causing fever and joint pain
	Massage Therapy				A general term referring to several practices of manipulating soft tissue for therapeutic purposes. Massage incorporates manual touch to improve circulation, relax muscles, improve range of motion, and increase endorphin levels. Healthcare providers are recognizing massage therapy as a legitimate aid for lower back pain	Patients typically pursue massage therapy in addition to medical treatment. Forms of massage therapy include neuromuscular therapy, sports massage and Swedish massage. Neuromuscular therapy, the most effective massage treatment for low back pain, consists of alternating levels of pressure applied to muscles to alleviate muscle spasm
MVC	Maximal Voluntary Contraction
	McLaughlin pin and plate
	Medial				Towards the mid-line, near the middle or away from the side
	Medial circumflex femoral artery				The artery around the femoral neck that is removed in Total Hip Arthroplasty but saved in Hip resurfacing
AIS	Median Abbreviated Injury Score
	Medical Device Reporting				The means by which adverse events and malfunctions with medical devices are reported to the Food and Drug Administration. Under the Safe Medical Devices Act of 1990, device user facilities including hospitals and nursing homes must report known device-related deaths to the FDA and the manufacturer. Medical Device Reporting was implemented in order to equip the FDA with the information necessary to detect and correct medical device malfunctions and ensure safety in the healthcare industry
	Medullary canal				The canal of the femur that is left untouched in hip resurfacing and when a BMHR is used. On the contrary with Total Hip Arthroplasty the femoral neck is removed and this medullary canal used to fit the shaft of the prosthesis in by either using a cementless approach or the use of bone cement
MAP	Mean Arterial Pressure
MPAP	Mean Pulmonary Artery Pressure
	(Robert) Merle d´Aubigné hip score	Pict.
	Metabolism				Metabolism refers to the sum of chemical changes that take place in a cell. This consists of Anabolism (a energy consuming, body building process) and Catabolism (energy giving, breakdown process). In Anabolism small molecules are converted into bigger ones and in catabolism big molecules are broken down into smaller ones giving energy
MARS-MRI	Metal Artefact Reduction Sequence - Magnetic Resonance Imaging
MoM	Metal on Metal				A replacement hip joint in which both parts, or both surfaces, are metal
MMSR	Metal-on Metal Surface Replacement
MoP	Metal-on-Polyethylene				A replacement hip joint with a relatively small metal head on a shaft or stem and an acetabular socket insert of polyethylene
	Metalosis				A nonsuppurative osteomyelitis that occurs around metal implants as a result of corrosion or hypersensitivity reaction	The implants can loosen ar a result
	Metaphyseal				Pertaining to the metaphysic (the extremity of a long bone)
	Metaphyseal-Diaphyseal Angle
MDI	Metaphyseal-Diaphyseal Index
	Metaphyseal fracture
MRSA	Methicillin-resistant Staphylococcus aureus
	Microdiscectomy				With microdiscectomy or microdecompression, a small portion of the bone over the nerve root and some of the disc material from under the nerve root is removed to relieve pressure on the nerve and provide room for the nerve to heal	A microdiscectomy is typically performed for lumbar herniated disc and is more effective in relieving symptoms of leg pain than for low back pain
	Migration				A hip complication resulting from a movement of the device out of its original position
MAR	Mineral Apposition Rate
MIS	Minimal invasive surgery				Surgery whereby incisions are minimized to reduce trauma to the body. This type of surgery is usually performed using thin-needles and an endoscope to visually guide the surgery. The goal of minimally invasive surgery is to reduce postoperative pain and blood loss, speed recovery and lessen scarring	Minimal invasive surgery is not in every respect the best approach for surgery. For example a Swedish report over 2005 shows a 15,8% high revision rate after application of the MIS/2 approach in Total Hip Arthroplasty, similar data exists internationally.
MIHR	Minimally Invasive Hip Resurfacing device
MIC	Minimum inhibitory concentrations
	Mobilization				Mobilization is a manual therapeutic technique that fosters movement in stagnant tissues and joints. Mobilization uses massage to break down scar tissue and restrictions that are typically associated with trauma to the soft tissue such as a strained muscle or pulled ligament. By re-introducing small amounts of pressure to the affected area, the rate and amount of blood flow increases in and around the area due to the temporary inflammation	Mobilization is based on the theory that the manual manipulation will help initiate and promote the healing process of the affected soft tissues
MBRSA	Model-based Roentgen Stereophotogrammetric Analysis				MBRSA allows a highly accurate in vivo measurement of three dimensional implant migration relative to the surrounding bone by using pose-estimation of geometric surface models of a prosthesis
	Modified Chiari (pelvic) osteotomy
	Modified shelf osteotomy
MTRO	Modified Transtrochanteric Rotational Osteotomy
	Modular				Composed of interchangeable parts. With respect to prostheses, femoral hip prostheses are most commonly modular in design. Different types of femoral implants have interchangeable heads, necks, and/or stems
	Monoarticular
	Morbidity				The incidence of ill health
	Morrison lock-bolt
MHE	Multiple Hereditary Exostoses	Pict.			Exostoses are bony bumps on bones in the body which can vary in size, location and number depending on the individual. Although any bone can be affected, the long bones (legs, arms, fingers, toes), pelvis and shoulder blades are the most common, while the face and skull are generally unaffected
MOF	Multi Organ Failure
MD	Muscular dystrophy				A broad term that describes a genetic (inherited) disorder of the muscles. MD causes the muscles in the body to become very weak. The muscles break down and are replaced with fatty deposits over time. The most common form of MD is called Duchenne muscular dystrophy (DMD)
MFA	Musculoskeletal Function Assessment				The MFA is a validated, patient questionnaire that measures patient satisfaction over time. The questionnaire will be completed at each interval and scored using the MFA algorithm
	Mutagenicity				The property of being able to induce genetic mutation
NAC	N-acetyl-L-cystiene				An amino acid derivative sold as a nutritional supplement, it has antioxidant properties
	Naropin				Naropin (ropivacaine hydrochloride) is used for surgical procedures to block feeling in the part of the body affected (local anaesthesia), so that the patient does not experience pain. Naropin can also be used for pain control following surgery and during childbirth. Naropin is injected, as a solution and producing local anaesthesia in that part of the body requiring the surgical procedure or pain control.
NKO	National Competence center for Orthopaedics		Nationellt Kompetenscentrum för Ortopedi
NJR	National Joint Registry (UK)
NOF	Neck of Femur
NL	Neck-length
NSA	Neck-Shaft Angle				An angle decided by the femoral neck center line and the femoral shaft center line
	Necrosis				Death of cells or tissues through injury or disease, especially in a localized areas
	Needle holder				A device in different sizes used to hold suture needles. The jaws have serrations in a crosshatch fashion for better grip. A ratchet mechanism on the holder near the fingers assures that the needle is kept tight between the jaws.
	Neoplasia
	Nerve block				Nerve block is a pain management technique involving the injection of an anesthetic into the area surrounding an affected nerve. The technique is used to treat nueropathic pain or to determine if a particular nerve is responsible for a pain by interrupting pain signals to the brain. An injection of steroids, local anesthetics, or opoids can effectively produce short-term back pain relief
	Neurovascular
NISS	New Injury Severity Score
NWB	Nil Weight Bearing
	Noncannulated cortical screw
	Non-displaced Fracture				The least serious type of fracture. In addition to the bone cracking, there can be tendon and ligament damage. In spite of this, the broken pieces remain aligned
NIDJD	Non-Inflammatory Degenerative Joint Disease					NIDJD is an indication for hip resurfacing if the remaining bone stock is adequate
NSAID	Non-Steroidal Anti-Inflammatory Drug				NSAIDs do not contain corticosteroids and are used to reduce pain and inflammation. Aspirin and ibuprofen are the two commonly used NSAIDs. These drugs are the first line treatment for arthritic pain. They reduce pain by interrupting the cycle of inflammation that causes pain in diseased joints. NSAIDs do not alter the course of degenerative arthritis, and none of them restore cartilage. Celebrex, Vioxx and Bextra are the newest in this class of drugs and have the advantage of reduced gastrointestinal side-effects. Previous NSAIDs such as Naproxen, Relafen, Feldene and others may be equally effective for some patients. The pain and stiffness of early osteoarthritis will respond very remarkably to Tylenol or one of the NSAID drugs. It is distinctly unwise to embark on any reconstructive surgery of an arthritic hip or knee without trying an NSAID type drug first, because the majority of patients can achieve pain relief for many years and avoid surgery entirely	NSAIDs are cleared from the blood stream by the kidney; thus, precautions should be taken to avoid kidney damage and disease when NSAIDs are taken over an extended period. Side effects of NSAIDs include stomach ulcers and kidney and platelet dysfunction
	Non-union	Pict.
	Notching				See: Femoral head notching
	Obesity				The state of overweight with a BMI (Body Mass Index) of 30 or higher is
	Oblique fracture				An angular break in the bone
	Occult fracture				A fracture that does not appear in x-rays, although the bone shows new bone formation within three or four weeks of the fracture
	Oligotrophic
	Onlay				A hip resurfacing prosthesis from the company ESKA that has an additional bearing insert and some other features like three prongs in the femoral head and a very thin femoral cap that sets it apart from usual resurfacing protheses.
ORIF	Open Reduction and Internal Fixation				Surgery using metal implant devices to hold a bone in alignment. The devices may be permanent or removed after the fracture has healed depending on the nature and location of the fracture	Patients who undergo an ORIF are at risk for developing an infection. The formation of heterotopic ossification (HO) is common following ORIF for acetabular fracture, followed by the total hip arthroplasty. Following THA, the incidence of HO has been reported as being between 5 and 90%, though only 3 to 7% of patients experience clinically significant HO whereby the outcome of the surgery is affected and designated grade of III or IV under the Brooker classification
OWO	Opening Wedge Osteotomy				The attempt to transfer the forces of the body weight onto the normal, non-arthritic side, by actually changing the angulation of either the tibia or the femur bone. In the Opening Wedge method this is done by cutting a wege into the bone and prising it open on the collapsed side. Plates and screws are used to keep the bones together and lined up. See also 'Closing Wedge Osteotomy".
	Orthofix Physio-Stim Bone Growth Stimulator
ODEP	Orthopaedic Data Evaluation Panel (UK)