Articular capsule

Synovium—Synovial membrane, the inner of the two layers of the articular capsule of a synovial joint, composed of loose connective tissue and having a free smooth surface that lines the joint cavity. It secretes the synovial fluid. 

Willert H.G. 1977. Reactions of the articular capsule to wear products of artificial joint... 

Willert, H., Semlitsch, M. (1976) Reactions of the articular capsule to joint prostheses. In Biocompatibility of Implant Materials, D.F. Williams (ed.), London, Sector Publishing, pp. 157-169. 

The membranes were tested through a lateral parapatellar skin incision 5-7 cm, followed by incisiOTi of the retinaculum and articular capsule, until the exposure of the knee joint. With the limb in extension the patella was displaced by promoting the exposure of the femoral trochlea (Fig. 21.22a) (lamaguti et al. 2008). 

Skeleton Renal phosphate diabetes associated with hypercalciuria may lead to osteomalacia or osteoporosis. Likewise, inflammatory or degenerative arthrosis is thought to be a late manifestation of Wilson s disease. (354) Often, these developments are combined with intra-articular calcium deposits and chondromalacia, in particular patellar chondromalacia. Bone fractures are frequently observed even with minor traumas. Calcification may occur in articular cartilage, capsule and tendinous insertions, and deposits of calcium pyrophosphate dihydrate can appear in the intervertebral disks. 

GRAS listed. Accepted as a food additive in Europe. Included in the EDA Inactive Ingredients Guide (dental preparations inhalations intra-articular, intrabursal, intradermal, intra-lesional, IM, intrasynovial and SC injections oral capsules, drops, solutions, suspensions, syrups and tablets topical and vaginal preparations). Included in nonparenteral medicines licensed in the UK. Included in the Canadian List of Acceptable Non-medicinal Ingredients. 

IP injection at dose levels of Ig/Kg body weight produce no mortality. In pigs and rabbits, osmarins of high molecular weight stain the joint capsules and articular surfaces of injected joints irreversibly. In limited experimental treatments of arthritic dogs, improvements have been noted in five of six cases. It is proposed that, in vivo, osmarins may react with superoxide ion and remove this damaging species. 

Figure 3 is a photograph of a stained joint. The osmarin used in this case contained 35% osmium as a dry solid. All surfaces within the synovial space were stained, articular cartilage on the joint surfaces and the joint capsule which encloses the space. The most proximal lympth node was stained (not shown). 

Tissue samples for microscopic study were obtained from pigs sacrificed one month after injection. Samples were obtained from the joint capsules and articular surfaces. When arthritic lesions were found, samples from these areas were obtained. 

Wear particles produced by abrasion appear essentially in the vicinity of articular pros-theses and of implants with a certain mobility, for example, uncemented total hip replacements. These wear particles may induce multiple tissue reactions osteolysis, degradation of normal bone structure, severe macrophagic reactions, granuloma, fibrotic capsules, inflammatory and immune reactions which may cause destabilization and loosening of prostheses and implants (Dorr etal. 1990 McKellop etal. 1990 Sarmiento and Gruen 1985 Weiss-man et al. 1991). 

The most common type of injury due to combined tension and extension of the cervical spine is the whiplash syndrome. However, a large majority of such injuries involve the soft tissues of the neck, and the pain is believed to reside in the joint capsules of the articular facets of the cervical vertebrae [Wallis et al., 1997]. In severe cases, teardrop fractures of the anterosuperior aspect of the vertebral body can occur. Alternately, separation of the anterior aspect of the disk from the vertebral endplate is known to occur. More severe injuries occur when the chin impacts the instrument panel or when the forehead impacts the windshield. In both cases, the head rotates rearward and applies a tensile and bending load on the neck. In the case of windshield impact by the forehead, hangman s fracture of C2 can occur. Garfin and Rothman [1983] suggested that it is caused by spinal extension combined with compression on the lamina of C2, causing the pars to fracture. 

The ACL is intra-articular and completely surrounded by synovium from the posterior capsule, thus making it extrasynovial. Proximally, it is attached in the shape of a semicircle, with the anterior border straight and the posterior border convex, to the posterior aspect of the medial surface of the lateral femoral condyle. Distally, the ACL is attached to a fossa anterior and... 

Ligaments are cord-like or flattened peri-articular structures that join articular bone ends. They keep joints in optimal alignment during motion limiting excessive wear, and prevent excessive joint excursion, thus preventing subluxation or dislocation. Ligaments may blend in with the joint capsule or... 

The articular surfaces of the elbow are contained within the joint capsule, which also encloses non-articular surfaces, including the coronoid, radial fossa and olecranon fossae. It attaches just distal to the coronoid and olecranon processes. The whole of the radial head is within the capsule. 

Figure 21.4. Immuno-staining for cartilage specific collagen lype 11 molecules within matrix synthesized by embedded cultured human articular chondrocyte cells (500,000 cells per capsule). Staining of new matrix is strong throughout each sampled capsule. Individual cells are located in well-defined lacuane at a high density. New matrix is not formed in capsules containing primary hBMSC.

As with neuraxial injections, the concept of articular injection is to provide a high concentration of drug proximal to the location of the suspected origin of pain. Although intra-articular deposition certainly will produce a high concentration inside the joint, there is still a debate as to whether this is the major relevant site for pain treatment, as much of articular pain is believed to be mediated from structures outside the joint cavity, such as tendons, connective tissue, capsules, and muscle. Also, there is a concern that high concentration of intra-articular corticosteroid may have deleterious effects on cartilage and bone, as reported in some rare cases. 

Articular stabihty is a cortrbined furrction of the shape of the joint, its hgamerrtous and muscular attachments, the strength of its capsule, and the balance of joint pressine to atmospheric pressure. Variation in any of these factors may contribute to somatic dysfunctions. 

The second functional joint is the scapulothoracic joint. This is formed by the scapula and the posterior thorax (ribs). Because muscle and fascia lie between the articulating surfaces, it is not a true joint with approximated articular surfaces and is also lacking a capsule. 

The articular disk is fibrous and is molded to the bony surfaces. It is variable in thickness, being thinnest centrally. Its margins merge with the joint capsule. The disk is more firmly attached to the mandible than to the temporal bone. Therefore, when the head of the mandible glides anteriorly on the articular tubercle (as... 

Hyoid articular area on posterolateral angle of otic capsule. Absent (0) present (1). 

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