Abstract
Joint stiffness may be explained by the following: (1) contractures of muscle, joint capsules, and ligaments; (2) capsular distention from effusion or synovitis; (3) intra-articular free bodies from meniscus tears, villonodular synovitis, synovial plica, etc; (4) joint surface incongruity; and (5) pain inhibition. ‘-‘I In OA, contractures and pain are early principal factors, but intraarticular free bodies (torn menisci, joint mice, etc) and surface incongruity are important in more advanced disease. Absence of motion has profound effects on the joint. Studies of joint immobilization have reported cartilage fibrillation, erosion, loss of metachromasia, degeneration, and necrosis of chrondrocytes.12 Immobilization experiments emphasize the need of motion for maintenance of articular cartilage health. How much loss of motion is required to adversely affect articular cartilage, however, remains unknown.
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