Accessory or supernumerary bone: Develops from separate center of ossification from parent bone; may or may not obtain bony union with parent bone.

Active-assisted motion: Range of motion (ROM) of a joint that a patient is able to achieve with the assistance of the examiner.

Active motion: ROM of a joint that a patient is able to achieve on his or her own.

Allograft: Cadaver graft.

Anatomic axis (of lower extremity): Angle formed by intersection of lines through the femoral and tibial shafts with patient standing. The difference between the mechanical and anatomic axis is usually 5+/−2 degrees.

Apophysis: Secondary growth center forming bony outgrowth or contour that remains a part of the native bone (e.g., process, tubercle, tuberosity).

Apophysitis: Inflammation of an apophysis.

Arthritis: Deviation from normal structure and physiology of joint tissues; a form of joint disorder that involves inflammation of one or more joints.

Arthropathy: Joint disease; does not specify the type of joint disease.

Arthrosis: An arthrosis is a joint; an area where two bones are attached for the purpose of motion of body parts.

Atrophy: Muscle “wasting”; loss of muscle mass.

Autograft: Graft from one’s own body.

Avascular necrosis (AVN), aseptic necrosis, osteonecrosis: Blood supply to affected bone is insufficient, resulting in bony necrosis; etiologies include idiopathic, traumatic, steroids, heavy alcohol use, dysbaric illness (Caisson disease), blood dyscrasias (e.g., sickle cell disease), high doses of radiation therapy, and Gaucher disease. Untreated, the natural disease progression is to degenerative joint disease.

Avulsion fracture: Injury to tendinous insertion site where a small piece of bone is fractured in continuity with the tendon, rather than rupture at the tendon-bone interface.

Bone bruise: Microfractures seen on magnetic resonance imaging. This is common with anterior cruciate ligament (ACL) injuries; with this injury, the lesions are located on the posterior portion of the lateral tibial plateau and the lateral femoral condyle.

Bursitis: Inflammation of a bursa.

Chondromalacia: Softening or damage to the articular cartilage of the patella; diagnosis is made under direct visualization at the time of surgery. This term is often used to describe similar lesions in other bones.

Chondrosis: Chondral degeneration.

Diaphysis: Midshaft, tubular portion of long bone.

Dislocation: Complete loss of apposition of articulating bones that normally comprise a joint.

Effusion: Excessive fluid within a joint.

Epiphysis: Center of ossification; longitudinal growth center.

Extension lag: Lack of normal active extension of a joint with normal passive extension; usually measured in degrees.

Flexion contracture: Lack of normal active and passive extension of a joint usually measured in degrees.

Instability: Functional term referring to symptomatic joint laxity; may be unidirectional or multidirectional, with the etiology being posttraumatic or congenital.

Laxity: Degree of looseness; usually referring to a ligament. Symptomatic laxity is termed “instability.”

Long bone: Length > width; found in limbs.

Mechanical axis (of lower extremity): Angle formed by intersection of lines drawn from center of femoral head to center of knee joint, and center of knee joint to center of ankle with patient standing.

Metaphysis: The growing portion of a long bone that lies between the epiphyses (the ends) and the diaphysis (the shaft); consists of cancellous bone.

Osteochondritis dissecans (OCD): A fragment of subchondral bone and its overlying chondral cartilage are separated from the underlying bone. The etiology is unclear, but most likely traumatic. Most often, it occurs in the knee, and the most common location is the lateral aspect of the medial femoral condyle.

Osteotomy: Transection of a bone; often refers to the tibia or femur to correct for varus or valgus deformities. The surgeon alters the mechanical axis of the limb in an attempt to alleviate malalignment, arthrosis, and pain.

Passive motion: ROM of a joint performed by the examiner.

Physis: Growth plate; the segment of a bone that is responsible for lengthening. There are four zones within the physis: the resting cartilage zone, the proliferating cartilage zone, the zone of hypertrophy, and the zone of calcification.

Platelet-rich plasma (PRP): PRP is blood plasma that has been enriched with platelets. As a concentrated source of autologous platelets, PRP contains (and releases through degranulation) several different growth factors and other cytokines that stimulate healing of bone and soft tissue. Localized injections of autologous blood with a supraphysiologic concentration of platelets are thought to enhance the healing process via a variety of potential mechanisms (13).

Proprioception: Reflex mechanism whereby position sense receptors are able to detect the position of a joint in space and therefore provide a coordinated muscular response to aid in stabilization of a joint.

Recurvatum: Hyperextension of a joint.

Sesamoid bone: Bone located within tendons.

Short bone: More cuboidal in shape; found in carpus and tarsals.

Sprain: Injury to a ligament(s) around a joint; due to excessive stress

Strain: Injury to a muscle or tendon due to excessive stress.

Stress views: Radiographs used to assess ligamentous integrity by stressing the involved ligaments and assessing for increased laxity; often compared to the normal contralateral side.

Subluxation: Partial dislocation of a joint.

Tendonitis (tendinitis): Inflammation of a tendon.

Tendonopathy (tendinopathy): Refers to injury or disease of a tendon.

Tendonosis (tendinosis): Tendon degeneration (usually focal); suffix “osis” implies a pathology of chronic degeneration without inflammation (16).

Tenosynovitis: Tendon sheath inflammation.

Tensile strength: Maximum stress that a structure can sustain before failure.

Bias: Deviation of results or inferences from truth; systematic error in the design, conduct, or analysis of a study that results in a mistaken estimate of an exposure’s effect on the risk of disease. Common forms of bias include selection and information bias.

Confidence interval (CI): Accuracy of the study; the CI is the range of high to low values of the data with the true mean likely to be in the specified range (usually 90% to 95% CI acceptable). A narrow CI is good. If, when evaluating relative risk, the CI crosses 1, there is no real difference between groups.

Confounding: A confounding variable (confounder) is an extraneous variable that correlates (positively or negatively) with both the dependent variable and the independent variable. Scientific studies therefore need to account for these variables either through controls or through statistical means; otherwise, an erroneous conclusion can be made that the dependent variables are in a causal relationship with the independent variable.

Incidence: The number of new cases of a disease or injury that occurs during a specified period of time in a population at risk.

Number needed to harm (NNH): Number of people needed to receive treatment to produce an adverse event. NNH = 1/Absolute risk increase.

Number needed to treat (NNT): Number of people to be treated to prevent one more event or adverse outcome. NNT = 1/Absolute risk reduction.

P value: The P value gives the interpreter the probability that the study results occurred by chance alone; acceptable P values are generally ≤ 0.05 and considered to be statistically significant.

Positive and negative predictive values (Table 4.1): Percentage of patients with a positive or negative test for a disease who do or do not have the disease in question.

Power:

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