Glossary of terms


A

A/P

Anterior/Posterior (anatomic terms)

AAOS

American Academy of Orthopedic Surgeons

Abdomen

A portion of the body between the thorax and pelvis

Abduct

To draw away from the midline

Abduction

The act of drawing away from the midline; opposite of adduction

Abductor

A muscle performing the function of abduction

Abscess

Localized collection of pus

Acetabulum

The cavity in the os coxae (hip) into which the head of the femur fits

Acromion

Bony process of the scapula which forms the point of the shoulder

Acute

Severe and/or short duration; used in speaking of duration and severity of disease

Adamant

Extremely hard, as enamel of tooth

Adduct

To draw toward the midline

Adduction

The act of drawing toward the midline; opposite abduction

Allograft

A tissue transplanted to a different individual of the same species

Alloy

A mix of metals designed to improve implant material properties for specific purposes

All-poly

A component composed entirely of polyethylene, with no metal parts

Amphiarthrosis

A joint with little movement and no joint cavity

Anconeus

Pertaining to the elbow

Ankylosis

The fusion of a joint

Anteflexion

A forward curvature; a condition in which the upper part of an organ is bent forward; opposite of retroflexion

Anterior

Placed in the front or forward part; opposite of posterior

Anteversion

A forward turning; a condition in which an entire organ is abnormally tipped forward

Apex

Top or summit

Aponeurosis

A flat sheet of white fibrous tissue, usually serving as an attachment for a muscle; plural aponeuroses; aponeurotica, Latin adjective

Appliance

Device used in support or fracture fixation external or internal

Apposition

The state of being fitted together, being in contact at the ends (see also mineral apposition)

Aqueous

Watery

Arthritis

Inflammation of a joint

Arthrodesis

Fusion of a joint, eliminating all motion

Arthroplasty

The surgical reconstruction of a joint

Arthrosis

A joint: from the Greek

Arthrotomy

Cutting into a joint

Articular

Pertaining to a joint; surfaces that "fit together"

Articulation

Movement of a joint; from the Latin

Asepsis

A condition free from germs; free from infection

Aspect

Position, surface, or face

Aspirate

To remove by suction

Asymmetric design

A design which mirrors the natural, anatomic contours of a joint, a design which comes in right and left configurations

Atrophy

A wasting away of tissue usually through disuse

Autograft

A tissue transplanted from one part to another part of the same body

Autonomic

 Being self-controlled; independent

Axial

 Pertaining to the axis or line about which a body turns, therefore pertaining to the trunk; opposite of appendicular

B

Beads, beaded

Term used to describe implant coatings made of tiny spheres (beading)

Biaxial

Turning about two axes (having two axes)

Biconcave

Having two concave surfaces

Bilateral

Occurring on both sides of a midline point or pertaining to both sides of the body (ex. bilateral knee replacement means having both knees replaced)

Biocompatibility

Materials that can coexist with living tissue without being harmful or toxic or being rejected by the host. The most common materials for joint replacement are polyethylenes, metals and ceramics, each has specific biocompatible characteristics

Biomechanics

The study of the relationship between forces and motion in biologic systems like the human body

Bipolar

Having two poles or processes

Blood

A fluid tissue circulating through heart, arteries, veins, and capillaries

Bone cement

Material usually made of polymethylmethacrylate (PMMA) which acts like a grout between an implant and the patient’s bone (see also cement)

Brachial

Pertaining to the arm

Broach

A tool or instrument used to enlarge the interior canal of bones to allow for insertion of implants, broaching is the process of enlarging the canal

C

Cage

A type of spinal implant

Calcaneus

The heel bone; also termed calcaneum

Calcar

A thickened plate of bone near the head of the femur

Cancellous

Lattice-like bone structure; softer bone

Cancellous bone

A type of bone characterized by a spongy or lattice-like structure. Also known as Trabecular Bone.

Cancellous-structured titanium

A specially-manufactured, patented type of titanium coating that permits bone ingrowth because of its lattice-like surface texture. (see also CSTi)

Capitate

Bone of the wrist having head-shaped process.

Capitulum

Little head.

Capsular

A ligament which surrounds a movable joint.

Caput

Head; capitis, "of the head."

Carpal

Pertaining to the wrist.

Carpus

The wrist; carpi, "of the wrist."

Caudal

Pertaining to any tail-like structure; inferior in position.

Cement

Material usually made of polymethylmethacrylate (PMMA) which acts like a grout between an implant and the patient’s bone. (Bone cement)

Cemented

An implant which is secured in a patient’s body with the aid of bone cement or the process of using cement to help fix an implant.

Central

Situated in the midportion as opposed to peripheral.

Chronic

Of long duration; opposite of acute.

Circumduct

To rotate in a cone shape around a single point, as in the shoulder joint.

Circumflex

Bent or turned about.

Clavicle

The collar bone

Clinical pathway

Established methodologies and decision trees for use by health professionals and patients in planning and preparing for medical intervention.

Coatings

Any number of different materials applied to the surface of an implant or prosthesis to aid in fixation; porous coatings generally permit ingrowth into the implant. (see also porous, beads)

Cobalt-chrome

A metal alloy with excellent resistance to fatigue, cracking and stress, widely-used in orthopedic implants. (also see CoCr)

Coccyx

Last, lowest portion of vertebral column (tailbone).

CoCr

Cobalt Chrome Alloy, a metal alloy with excellent resistance to fatigue, cracking and stress, widely-used in orthopedic implants.

Collar, collared

The top edge of a hip stem implant which rests on the top edges of the bone in which it was implanted.

Component

A part of an implant system, for example the patellar component is that piece that either replaces or enhances the original patella (knee cap).

Concave

Having a depressed surface; center is at a lower level than edge; opposite of convex.

Condyle

A rounded knob on the end of a hone; a knuckle.

Condyloid

Resembling a knuckle.

Congenital

Present at birth, as in CDH, congenital dislocated hip.

Congruent

The degree of constraint of two articular implants. (congruence)

Convex

Having a rounded elevated surface; opposite of concave.

Coracoid

Like a crow's beak; variant of coronoid.

Costal

Pertaining to a rib or ribs.

Coxa

The hip; coxae, "of the hip."

Cranial

Pertaining to the cranium.

Cranium

The skull or brain pan.

Cruciate

Shaped like a cross.

Cruciate ligament

Any paired set of ligaments that cross over each other in an "X" formation, usually used to refer to the posterior cruciate ligament and the anterior cruciate ligament of the knee, which help stabilize the forward and backward motion of the knee.

Cruciate-retaining

A knee system design that allows the surgeon to keep the patient’s cruciate ligament.

Cruciate-sacrificing

A knee system in which the design of the implant must serve to stabilize the forward and back motion of the knee components because of an excised or deficient patient’s ligament. (see also PS)

CSTi

A specially manufactured, patented type of titanium coating that permits ingrowth because of its lattice-like surface texture. (see also Cancellous-structured titanium)

Cubital

Pertaining to the tile space in front of the elbow joint.

Custom

An implant manufactured to the demands of a surgeon based on the specific needs of one patient

Cyclic fatigue

A biomechanical measure of stress placed on a material, measured in "cycles" of regular motion (as in joint motion - rotation, bending, etc.)

D

Deltoid

Triangular; resembling the Greek letter, delta.

Design rationale

The justification for an implant design based on extensive research into materials, clinical data, function, style, anatomical constraints, etc.

Diagnosis

Recognition of disease from symptoms.

Diathrosis

A freely moveable joint; plural diarthroses.

Digiti

Of a digit.

Digitorum

Of the digits.

Dislocation

The displacement of any part, especially the removal temporarily of a bone from its normal position in a joint

Distal

Remote; opposite of proximal.

Dorsiflex

To turn toward the back; opposite of palmar flex.

E

Endosteum

Tissue surrounding the medullary cavity of bone.

Epi

A prefix meaning "on" or "above", opposite of hypo.

Epicondyle

A prominence or a bone on or upon a condyle.

Epiphysis

A part of process of a bone which ossifles separately before making osseous union with the main portion of the bone; the "growth plate" of bones

Etiology

The study of the causes of disease

Eversion

The act of turning outward; opposite of inversion.

Evert

To turn out; to turn tile sole of the foot outward opposite of invert.

Extension

A movement at a joint bringing the two parts into or toward a straight line from a flexed position; opposite of flexion

External

On the surface or outer side; opposite of internal. Latin adjective, externus or externa

Extra

Prefix meaning "outside of," opposite of intra

F

FDA

Food and Drug Administration

Femur

Thigh; bone of the thigh; femoral is the adjective; femoris, "of the thigh." Smaller bone of lower leg; tile splint bone

Fixation

The act, process or operation of holding, suturing or fastening something into a fixed position. In orthopedics, often refers to the stability and immobilization of an implant into the patient’s body

Flexion

Sagittal plane movement in which the anterior surfaces of two segments are brought closer to each other; opposite of extension; bending of a joint

Flexure

The curved or bent part of a structure

Foramen

A hole; plural, foramina, or foramens

Fossa

A pit or hollow; plural, fossae

Fracture

A break in the continuity of bone

G

Glenoid

Resembling a pit or pocket. The glenoid fossa of the scapula is very shallow. Analogous to the acetabulum of the hip

GMP

Good Manufacturing Practices, part of total quality systems

H

Hallux

The great toe; hallucis "of the great toe"

Harris Hip Scores

A numerical rating scale used for evaluation of the hip. The Harris Hip Rating Scale evaluates pain, function, absence of deformity and range of motion. One hundred is the highest possible total.

HSS Knee Scores

Hospital for Special Surgery Knee Scores, a numerical scale for rating knees.

Humerus

The upper arm bone.

Hydroxyapatite (HA)

A bioactive calcium phosphate ceramic similar to normal bone, may be applied to implant surfaces.

Hyper

Prefix meaning above; opposite of hypo.

Hyperplasia

Increase in size of a tissue or organ due to an increase in the number of cells.

Hypertrophy

Increase in the size of a tissue or organ due to an increase in the size of its constituent cells.

Hypo

A prefix meaning below or under; opposite or epi or hyper.

I

IDE

Investigational Device Exemption (studies of experimental products).

Ilium

The bone of the flank; adjective is iliac; ilio is the combining form.

Implant

A device (or tissue or substance) that is transferred, grafted, or inserted into a living body. (see also stem, prosthesis)

Index

Referring to the forefinger or "pointing" finger.

Inferior

Situated or placed below; opposite of superior; inferioris, a Latin form of the adjective.

Infra

A prefix meaning "beneath," opposite of supra.

Ingrowth

The process of living bone or tissue growing up to and into the surface of an implant, very important for stabilization and long-term life of the implant. (bone or bony ingrowth)

Instrument

A tool or implement used in surgery.

Inter

A prefix meaning "between".

Interbody fusion

A surgical technique for achieving bony fusion between invertebral bodies, term used to describe a specific back surgery technique.

Interface

Surface forming a common boundary between two bodies (used to describe the interaction of implant and living tissue).

Internal

Within or on the inside.

Intra

A prefix meaning "within".

Inversion

The act of tuning inward; opposite of eversion.

Invert

To turn in; to turn the sole of the foot inward; opposite of evert.

Involuntary

Performed against the will or consent.

Ischium

Bone of the hip; adjective is ischiatic, ischial, or sciatic.

ISO

International Standards Organization, a standards issuing body.

K

Knee Society Score

A numerical scale for evaluating knee function developed by the Knee Society.

Kyphosis

An abnormal condition (curvature) of the spine; hunch-backed.

L

Lateral

Pertaining to the side; opposite of medial.

LD

Low-demand or low density

LDPE

Low Density Polyethylene

Ligament

Fibrous connective tissue connecting the articular ends of bones serving to bind them together and to facilitate or limit motion.

Lordosis

Abnormal anterior convexity of the lumbar spine.

Lumen

Space within a tube or organ.

Lunate

A bone of the carpus shaped like a crescent moon.

Luxation

Dislocation of a joint.

M

M/L

Medial/Lateral (anatomic term)

Major

Larger, opposite of minor, majus is neuter adjective.

Malleolus

A little hammer (mallet); a hammer-shaped process; ankle bone. Plural, malleoli.

Mandible

Bone of lower jaw.

Marrow

Soft central part of a bone.

Maxilla

A jawbone; particularly the bone of the upper jaw.

Media

Middle

Medial

Pertaining to the center; opposite of lateral.

Median

Pertaining to the middle; that is, between two other structures.

Meniscectomy

Removal of the meniscus cartilage of the knee.

Meniscus

A "C" shaped cartilage in the knee which provides a stabilization system for the knee and a measure of shock absorption

Metacarpus

Beyond the instep; the five bones of the foot between the toes and tarsal bone

Metal-backed

Term used to describe implants that have a polyethylene liner set in a metal shell or on a metal base, the metal portion would rest in a prepared area in the bone and the polyethylene side would move against other metal components

Minor

Smaller, opposite of major.

Morphology

The study of the structure of organisms, used colloquially to refer to the structure of body parts

N

Navicular

Boat shaped; carpal bone at the base of the thumb. Also called the scaffoid

Necrosis

Death of areas of tissue or bone surrounded by healthy tissue.

Non-porous

An implant designed to be used with bone cement for stabilization; a surface that is not designed for nor coated with surfaces for ingrowth

O

O.R.I.F.

Open Reduction, Internal Fixation.

Oblique

Slanting; between horizontal and vertical direction..; Latin adjective, obliquus

Olecranon

From the Greek word for elbow. The prominence at the proximal end of the ulna

Opposition

The act of opposing one part to another.

Orbital

Pertaining to the orbit (eye).

Organ

A group of tissues having a special function.

Orthopedics

Branch of medical science that deals with treatment of disorders involving locomotor structures of the body, especially the skeleton, joints, muscle, fascia.

Orthopedist

A physician specializing in orthopedics.

Os

Bone; Os coxae - hip bone.

Osmosis

Passage of fluid across a membrane from a lesser to a more highly concentrated solution

Ossification

Formation of bone.

Osteophyte

An abnormal bony outgrowth

Osteoporosis

Increased porosity of bone.

Osteotomy

Cutting and repositioning bone to more functional position.

Outcome management

The process of collecting, tracking and interpreting outcomes data

Outcomes

The results of surgery in terms of patient satisfaction, reduction of pain, improved function, etc. Outcomes are tracked by hospitals and practices.

Oxygenless

A patented procedure used by Zimmer in the packaging of polyethylenes where oxygen is removed from the packaging. Lab testing has shown the process decreases the wear rates of PE (polyethylene).

P

Palmar

The palm of the hand.

Para

Prefix meaning "beside," "accessory to" or near.

Patella

The kneecap

Patient Satisfaction Surveys

Surveys which seek to measure patients’ satisfaction with their surgery, recovery, etc. These form part of the outcomes data that surgeons and hospitals track.

Pearls

Expert surgical techniques developed by senior surgeons, often for particular implants or procedures. (see surgical pearls)

Pedal

Pertaining to the foot.

Pelvis

A basin or basin-like structure.

Peri

Prefix meaning "around."

Peripheral

Located on or near the surface of a part.

Pes

The foot; pedis, "of the foot."

Phalanges

Plural of phalanx, which refers to any bone of the finger or toe.

Plantar

Pertaining to the sole of the foot; plaritaris; Latin adjective plantae, "of the sole of the foot."

Plasma

Fluid portion of the blood.

Plasma spray

A coating for implants

Plastics

A common term that in orthopedic devices refers usually to polyethylene and more specifically to ultra-high molecular weight polyethylene (UHMWPE). (see also polyethylene, UHMWPE)

PMA

Pre-Market Approval (FDA approval after IDE study is complete).

PMMA

Poly methylmethacrylate (bone cement). (see also cement, bone cement)

Polyethylene

A type of plastic formed by the polymerization of ethylene. Different structural properties come from differences in molecular weight, branching, cross-linkage and crystallinity. The most common form used in orthopedic devices is ultra-high molecular weight polyethylene (UHMWPE).

Pore

Small holes or spaces on the surface or interior of a material.

Porous

Characterized by pores and open spaces.

Porous-coated

The design feature of a type of implant where the metal has small surface openings into which bone or tissue is intended to grow for permanent stabilization.

Posterior

Situated behind or toward the back; opposite of anterior.

Press-fit

Describes the fit at the interface of an implant with the surrounding bone; the implant is implanted without cement and is tightly "pressed" or impacted into the patient’s bone. (see also uncemented)

Primary

Initial or first; in joint replacement, this term is used to indicate the first surgery to repair or replace a joint as opposed to a revision surgery which replaces or revises an implant.

Process

A slender projecting point; Latin, processus.

Prognosis

The likely outcome of an illness

Pronate

To turn palm downward (opposite: supinate).

Prone

Lying with face downward (opposite: supine).

Prosthesis

Replacement of a missing part by an artificial substitute. An artificial organ or part.

Protract

To extend forward or outward; opposite of retract.

Proximal

Nearest; opposite of distal.

PS

Posterior Stabilized; a posterior stabilized knee is a type of semiconstrained total knee system that compensates for a deficient or absent posterior cruciate ligament through its surface geometry (its design minimizes forward and backward movement of the knee and substitutes for the function of the ligament).

Pseudarthrosis

A false joint developing after a fracture that has not united.

Pseudo

A prefix signifying "false.

PT

Premier Total

Pubis

Pubic bone

R

Radiolucent

Allowing x-rays to pass through, radiolucent areas appear dark on x-rays.

Radius

A bone of the forearm.

Ream,reaming

A verb meaning to gouge out holes or enlarge holes already made, in orthopedic surgery, bones need to be reamed to allow for the implantation of a prosthesis.

Recurvatum

Hyperextension of the knee.

Reduction

Restoration to normal position.

Retract

To pull back; opposite of protract.

Retrieve

To remove an implant from a patient (retrieved, retrieval)

Retro

Prefix meaning behind.

Retroflexion

A backward bending of one part of an organ on another portion; Opposite of anteflexion.

Retroversion

A backward turning; the entire organ is turned backward; opposite of anteversion.

Revision

In orthopedic surgery, this term indicates a subsequent surgery to alter, replace or remove an implant

Roentgenogram

A photograph made by means of roentgen rays or x-rays. The rays are named in honor of their discoverer.

Roentgenoscopy

Examination by means of a fluoroscope

ROM

The area through which a joint may be moved in all planes, measured in degrees. The greater the ROM, the more flexible the joint. One of the goals of joint replacement is to improve a patient’s ROM in the joint that may have been lost to arthritis, trauma or deformity. (range of motion)

Rotation

The act of turning about a centrally located length axis

S

Sac

Any bag-like organ

Sacrum

Five fused vertebrae below the last lumbar vertebra

Sagittal

Pertaining to the median vertical plane of the body

Scapula

The shoulder blade.

Scoliosis

Lateral abnormal curvature of the spine

Semilunar

Shaped like a half moon

Septic

Infection due to presence of pathogenlc organisms

Serrated

Having a saw-tooth edge

Serum

Clear portion of any animal fluid

Shear

A biomechanical term meaning a load applied parallel to the surface of a structure; shear strength is the amount of resistance in a material to angular deformation (bending) resulting from shear forces

Shell

The acetabular component, the part of a hip replacement system that serves for the hip socket

Sinus

A cavity

Skeleton

The hard framework of the body. The bones of the body collectively

Spinous

A spine-like process; Latin adjective, spinatus

SS

Stainless Steel

Stem

A device (or tissue or substance) that is transferred, grafted, or inserted into a living body (see also implant, prosthesis)

Sterile

Clean and free from all living micro-organisms

Sternum

The breast bone

Sub

Prefix meaning "below" or "beneath"

Subclavian

Beneath the clavicle

Subluxation

A partial or incomplete dislocation

Submaxillary

Beneath the maxilla

Subscapular

Beneath the scapula

Subsidence

The settling of a prosthesis after implantation; it is determined by comparing x-rays immediately after surgery to x-rays taken at a later date. Subsidence is a sure sign of loosening of an implant

Superior

Higher; opposite of inferior; superioris, a Latin form of the adjective

Supinate

To turn the palm of the hand upward (opposite: pronate)

Supine

Lying flat on the back (opposite: prone)

Supra

Prefix meaning "above;" super has same meaning; opposite of sub

Surgical pearls

Expert surgical techniques or tips developed by senior surgeons, often for particular implants or procedures

Surgical technique

A series of steps required to complete a surgical procedure (or operation)

Symphysis

A growing together

Synovectomy

An immovable joint

Synovia

A union of bones by means of cartilage

Synovial Membrane

A thin tissue that lines the capsule surrounding the joint

T

Talus

The ankle; a bone of the ankle. The tarsal bone articulating with the distal tibia and fibula.

Tarsus

(1) The instep; the seven bones forming the back portion of the foot (2) Connective tissue framework of the eyelids.

Telesession

An instructional course or lecture provided by one-way video, often a telesession consists of an expert surgeon discussing and/or demonstrating specific techniques or characteristics of an implant system.

Template

An outline used to trace bones in order to standardize its form; surgeons use templates of implants to measure against a patient’s x-rays to select the best size and best design for the patient’s anatomy and surgical needs.

Tendon

Fibrous connective tissue serving for the attachment of muscles to bones and other parts. Syn. - sinew

Tensile strength

A biomechanical measurement of the amount of stress required to cause a given material to fail.

Thoracic

Pertaining to the chest; thoracico or thoraco, containing forms

Ti

The abbreviation for Titanium, a metal often used in implants

Tibia

Latin name of shin bone. Larger bone in the lower leg. Pertaining to the tibia; Latin adjective, tibialis

Tissue

A collection of similar cells specialized to perform a particular function

Titanium

A metal often used in the manufacture of orthopedic devices or implants. It has good fatigue, wear and strength characteristics and is often combined with other metals in alloys which enhance desirable characteristics.

Trabecular

A type of mature bone commonly found at the ends of bones, it is composed of a latticework of bony plates and columns. Its structure gives trabecular bone a great deal of strength despite having less bony material than cortical bone.

Trochanter

Either of two bony processes of the upper femoral shaft for muscle attachment

Trochlear groove

The articular portion of the anterior surface of the distal femur (the front-facing notch at the lowest part of the femur where the femur joins the knee joint, this groove provides a shallow depression where the patella slides as the knee articulates).

Tubercle

A small rounded elevation of eminence on a bone

Tuberosity

Broad eminence on a bone

U

UHMWPE

Ultra-High Molecular Weight Polyethylene, a type of polyethylene with superior wear properties, very commonly used in orthopedic devices. (see also polyethylene, plastic)

Ulna

The inner and larger bone or the forearm; In the correct anatomic position, palms forward, the inner and larger bone of the forearm, between the wrist and the elbow, on the side opposite the thumb.

Ultra-congruent

Highly congruent, contains a high degree of constraint between two articular implants (see also congruent)

Uncemented

A prosthesis that is implanted without cement (see also press-fit)

UNI

Unicompartmental knee (also can be the abbreviation for unilateral)

Unilateral

One-sided, affecting only one-side (ex. a unilateral knee replacement would replace just one knee, not both) (see also uni)

V

Valgus

A term denoting position meaning bent outward (knock-knee) or twisted, applied especially to deformities in which a part is bent outward. Also increased femoral head-neck angle

Value-added services

This is a broad term that encompasses systems that help orthopedic customers (surgeons and hospitals) meet the demands of managed care, these systems are not directly related to orthopedic implants

Varus

(1) Turned inward; bowlegged. (2) A condition in which a clubfooted person walks on outer border of the foot. Also, decreased femoral head-neck angle

Vastus

Wide or great

Vertex

The summit or apex

Viscous

Sticky or gummy, thick fluid

Vitreous

Glassy

Voluntary

Performed in accordance with the will; opposite of involuntary

W

Wear

The loss of material from solid surfaces due to mechanical abrasion

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