The human skeleton is made of individual or joined bones (such as the skull), supported and supplemented by a structure of ligaments, tendons, muscles, cartilage and other organs.

The skeleton is not unchanging; it changes composition over a lifespan. Early in gestation, a fetus has no hard skeleton; bones form gradually during nine months in the womb. At birth, all bones will have formed, but a newborn baby has more bones than an adult. On average, an adult human has 206 bones (according to Gray's Anatomy, but the number can vary slightly from individual to individual), but a baby is born with approximately 270 bones. The difference comes from a number of small bones that fuse together during growth, such as the sacrum and coccyx of the vertebral column. An infant is born with pockets of cartilage between particular bones to allow further growth. The sacrum (the bone at the base of the spine) consists of five bones which are separated at birth but fuse together into a solid structure in later years. Growing is usually completed between ages 12 and 14, at which point the bones have no pockets of cartilage left to allow more growth.

Not all bones are interconnected directly. There are 6 bones, the auditory ossicles (three on each side), in the middle ear that articulate only with each other. Another bone, the hyoid bone in the neck, does not touch any other bones in the body, and is supported by muscles and ligaments; it serves as the point of attachment for the tongue.

The longest and heaviest bone in the body is the femur and the smallest is the stapes bone in the middle ear. In an adult, the skeleton comprises around 20% of the total body weight.

Arthritis (from Greek arthro-, joint + -itis, inflammation; plural: arthritides) is a group of conditions where there is damage caused to the joints of the body. Arthritis is the leading cause of disability over the age of 65.

There are many forms of arthritis, each of which has a different cause. Rheumatoid arthritis and psoriatic arthritis are autoimmune diseases in which the body is attacking itself. Septic arthritis is caused by joint infection. Gouty arthritis is caused by deposition of uric acid crystals in the joint and subsequent inflammation. The most common form of arthritis, osteoarthritis is also known as degenerative joint disease and occurs following trauma to the joint, following an infection of the joint or simply as a result of aging. There is emerging evidence that abnormal anatomy may contribute to early development of osteoarthritis.

Contents

• Definition of Osteoarthritis
• Symptoms of and tests for Osteoarthritis
• Types of Arthritis
• Causes of Osteoarthritis
• Treatment of Osteoarthritis
• Rheumatoid Arthritis

Prices in Germany are normally 75% below the cost of anterior cruciate ligament repair in the US and are individually quoted. They include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

• What is the Anterior Cruciate Ligament?
• Damage to the Anterior Cruciate Ligament?
• Three Options for Repair of the Anterior Cruciate Ligament
• Rehabilitation for the Anterior Cruciate Ligament Repair

Prices in Germany are normally 75% below the cost of an anterior hip replacement in the US and are individually quoted. They include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

• What is the Anterior Hip Replacement Surgery?
• What is the History of the Anterior Hip Replacement Surgery?
• What are the Advantages of the Anterior Hip Replacement Surgery?
• How Successful is Anterior Hip Replacement Surgery?

Prices in Germany are normally 75% below the cost of treatment for Avascular Necrosis in the US and are individually quoted. They include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, and pre-op diagnosis.

• Avascular Necrosis: Definition
• Avascular Necrosis: Causes
• Avascular Necrosis: Presentation
• Avascular Necrosis: Treatment

Avascular Necrosis: Definition

Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. Without blood, the bone tissue dies and causes the bone to collapse. If the process involves the bones near a joint, it often leads to collapse of the joint surface. This disease also is known as osteonecrosis, aseptic necrosis, and ischemic bone necrosis.

Prices in Germany are normally 75% below the cost of hand surgery in the US and are individually quoted. They include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

• Carpal Tunnel Syndrome.
• Dupuytren's Contraction
• Supinatorlogen Syndrome

Hip Abrasion Arthroplasty is an alternative to traditional total hip replacement surgery. Because hip replacements last between 10 to 20 years, hip abrasion arthroplasty should be considered before hip replacement or hip resurfacing, as a method or prolonging the life of the joint.

In Hip Abrasion Arthroplasty no prosthetics are attached permanently to the end of the bones. Rather the end of the bones (femur and sacrum) are removed with a burr to the depth of about 1 mm. In an attempt to heal themselves, the bones slowly exude a substance, which will eventually replace the lost cartiledge. Although this material is a bit harder than the original cartiledge, it works quite well.

Unlike arthroscopic knee and shoulder surgery, hip arthroscopy has seen advances only in the last few years thanks to the development of new surgical instrumentation. With the hip joint surrounded by a thick wall of soft tissue, mostly muscle, the joint space cannot be reached as easily as in the knee or the shoulder.

Liquid is also used when operating on the hip to facilitate the use of motor-driven instruments on the synovium, cartilage and bone. On completion of surgery, the tiny portals are closed with steri strips. In the majority of cases the patient is pain-free after surgery and very often the pain previously experienced is gone instantly. A patient being treated for arthritis of the hip must use crutches for 2 to 3 months to allow the replacement cartilage to grow out and mature. This technique, known as "abrasion arthroplasty", has been used with great success for more than 20 years. So far over 5,000 such knee operations have been performed for severe osteoarthritis.

To the right is a picture of the surface of the distal femur before >Hip Abrasion Arthroplasty. Here one can see the damage that bone lesions and arthritis cause to the bone. This damage excellerates the deterioration of the cartiledge.

The next picture to the right shows the surface of the distal femur after >Hip Abrasion Arthroplasty. Please notice the smooth surface. It takes six to eight weeks of walking on crutches and not applying the full weight of the patient on the bone to fully regenerate to this state. The stay in the clinic for Hip Abrasion Arthroplasty is usually two days with a three day stay in a hotel. Light amounts of therapeutic rehabilitation is necessary for a full recovery.

Prices in Germany are normally 75% below the cost of hip replacement surgery in the US and are individually quoted. They include all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

• What is Hip Replacement Surgery?
• What is the History of Hip Replacement Surgery?
• What does a Hip Replacement Look Like?
• What Are the Modern Advances in Hip Replacement Surgery?
• What Are Some of the Conditions that Lead to Hip Replacement Surgery?
• What are Some of the Variations in Hip Replacement Surgery?
• How Long will I be in the Hospital after Hip Replacement Surgery?
• Hip Resurfacing: An Alternative to Total Hip Replacement Surgery?

Prices in Germany are normally 75% below the cost of a hip resurfacing in the US and are individually quoted. The cost for hip resurfacing includes all medical expenses, the hospital stay, surgeon's fees, operation room fees, anesthesia, anesthesiologist's fees, medicine, nursing, semi-private room, meals, pre-op diagnosis, local phone and English TV.

• Three Types of Hip Replacement Surgery?
• What is Hip Resurfacing?
• Rehabilitation for Hip Revision Patients

Knee Abrasion Arthroplasty in combination with a high tibial osteotomy (HTO) is alternative to traditional knee replacement surgery. Because knee replacements last between 10 to 20 years, knee abrasion arthroplasty should be considered for patients below 60 years of age.

In Knee Abrasion Arthroplasty no prosthetics are attached permanently to the end of the bones. Rather the end of the bones (femur and tibia) are removed with a burr to the depth of about 1 mm. In an attempt to heal themselves, the bones slowly exude a substance, which will eventually replace the lost cartiledge. Although this material is a bit harder than the original cartiledge, it works quite well.

This is a two stage operation and requires partial rest and rehabilitation of the knee for two months. In the first stage the abrasion takes place, along with the placement of a metal brace. In the second stage, the metal brace is removed. Also this operation is considerably more expensive than the normal knee replacement surgery.