A New Transplant Procedure for Knee Pain

Treating knee pain can lead include injections, exercise, therapy, or surgery. When surgery stands alone as the last best option, a number of approaches and modalities are available.

Traditionally, knee surgery has involved some version of arthroscopy, cartilage repair, or partial or total knee replacement. But now a new and innovative approach is making waves after a series of human trials – cartilage transplantation:

For the study, Martin and colleagues took a small sample of cartilage cells from the patient’s nose bone, then grew more cells by exposing them to growth hormone for two weeks. All the cells were then placed in a membrane of collagen and cultured for two more weeks.

And the result?

Two years after the transplants, most of the patients grew new cartilage in their knees and reported improvements in pain, knee function and quality of life.

Of course more study is needed, and a wider range of demographics must be tested before this procedure secures a place among the field’s best practices. But as a preliminary step this first study is promising, and its ease could portend a far broader application of life-restoring knee surgery for chronic pain.

After Cortisone: Do I Need Knee Replacement Surgery?

The line for when knee replacement surgery becomes essential has shifted in recent years, as pain management and better therapies have extended the lives of our natural joints. But there comes a time in any patient’s life when she must contend with the question of knee replacement surgery – and wrestle with the pros and cons associated with each.

Total knee replacement surgery has an easier recovery period than it used to, but that doesn’t mean there isn’t work involved. Therapy, exercise, and proper management of the surgical site will still be required, so it’s worth engaging your orthopedist about what to expect moving forward. One article recently described the profile of an ideal TKR patient like this:

The major indication for joint replacement is not being able to deal with the pain anymore. The vast majority of patients after the surgery have significant pain relief and better function. The absolute key to success from this surgery is a motivated patient who works hard with physical therapy to regain range of motion and strength.

Sound like you? Get in touch with the San Diego Orthopedic Surgery Center and we can begin an evaluation right away.

The Overuse Epidemic of Sports Injuries in Kids

I have written about this before: many sports injuries in young people could be prevented by providing more reasonable timelines for rest, and creating longer offseasons. We could also help kids avoid injury by reducing the emphasis on single sport specialization, and dialing back the pressure overall.

It seems I am not alone. The American Medical Society of Sports Medicine recently issued a statement on the same problem, citing one member with a commonsense prescription:

“More and more kids are having adult-type surgeries,” she said, some from overuse or repetitive injuries. That kind of surgery, that was preventable. That didn’t have to happen. They throw too hard, too fast and they pitch through the pain…The risks of playing year-round are not only injuries, but burnout and getting sick of what they’re doing,” Bergeson said.

What’s the answer? Rest more. Relax more. Be a kid more. You can train hard when it’s time, but be sure and “clock out” enough to give your body time to recover, heal, and grow.

Ironically, too many injuries from overuse in a person’s early years can eliminate any chance of participating on a professional level in adulthood. So play the long game. And stop playing so much.

When To Get Shoulder Surgery

Shoulder surgery is a last option, but one which many thousands of people in Southern California opt for each year. The reason is simple: not every type of shoulder pain goes away on its own, and there are limits to what painkillers and analgesics can do.

Shoulder pain can arise for any number of reasons, from injury to bursitis to arthritis. Some of these issues are likely to heal over time, while others may involve lasting wear and tear whose effects are more or less permanent – and unrelenting:

Mild cases of shoulder pain can often be effectively treated conservatively, with options including rest, physical therapy, corticosteroid injections and anti-inflammatory medication. If conservative strategies fail, then surgery may be an option.

Shoulder surgery can take many forms, depending on the needs of each individual patient. At my San Diego orthopedic surgery offices, we take the time to review a full history and draw up a surgical plan that suits your lifestyle and medical history, and has the greatest chance of success. The results may be slow to appear, but they are also long lasting: shoulder surgery is a permanent fix for a wide array of common complaints.

Let’s Talk About Soccer Injuries in Pediatric Orthopedics

As a San Diego pediatric orthopedist, I see a lot of young people and their parents for sports injuries. In many cases, these injuries are simple bangs and twists which will heal over time – but for a small minority, pediatric sports injuries suggest a larger pattern which foretells future health issues down the line.

Soccer is a surprisingly common culprit for injuries such as these, especially given the recent attention that football has received. Like football, soccer is still a contact sport, and some evidence suggests that it’s becoming a more common source of injuries as well:

The injury rate for youth soccer players aged 7 to 17 more than doubled over the 25-year period ending in 2014, according to an analysis of children treated in U.S. hospitals. Even though concussions accounted for just 7 percent of these injuries, the annual rate of concussions surged by almost 1,600 percent during the same period.

Soccer is certainly growing more popular, and that fact alone could account for some of the increase: no one has done a “per capita” study that I’m aware of. But there is a second hypothesis which may have some merit as well: the incidence of injuries has stayed flat, but parents and coaches are much more cautious today than they used to be about seeking medical care:

It’s also possible some of the increase in injuries came from a growing awareness of concussions and head traumas that prompts more kids to be treated in hospitals, Xiang said.

Whatever the case, it’s important to get treated and provide some test for young athletes as soon as possible. For the best sports medicine for kids in San Diego, contact the San Diego pediatric orthopedic offices of Dr. William Holland, MD, today.

Identifying the Causes of Knee Pain

Knee pain can wax and wane without any apparent reason. For some people, it begins as a stabbing sensation which resolves over time; for others, the pain is dull but chronically escalating. And as we have recently learned, knee pain can be a harbinger of referred pain that spreads throughout the body.

Naming and describing knee pain properly is one of the keys to making a good diagnosis. The Chicago Tribune recently tackled this topic, reviewing some of the common questions you are likely to hear when you visit your doctor:

Faced with a painful knee, doctors will take a history: Did you injure yourself? Did you change your exercise regimen? “All can lead to inflammation of the knee,” says Damle, who has a private practice in Wakefield, R.I.

Your doctor will examine the knee. “You might see fluid buildup, a decrease in the range of motion or difficulty bearing weight,” Damle says. These symptoms may indicate a serious injury such as a ligament tear, which may prompt an MRI scan and a referral to an orthopedic surgeon.

That’s where I come in. As a leading San Diego orthopedic surgeon, I see a number of patients complaining of knee pain. Taking a history can help to dispel the mystery, but sometimes the onset is gradual and subtle enough that no one can pinpoint an immediate point of origin. That’s why I endeavor to learn as much as I can about each patient’s habits, lifestyle choices, and vocation to make a good diagnosis.

Orthopedic knee pain is a widespread problem; visiting an effective orthopedist can help. Reach out today to get the best treatment for knee pain in San Diego.

Knee Pain Leads to Pain Everywhere

Referred pain is a phenomenon where pain in one part of the body can spread, almost by osmosis, to affect unrelated joints and tissues. Referred pain accounts for a number of common headaches, as well as some cases of arm, elbow, and wrist pain which may in fact originate in the shoulder.

The mechanisms behind referred pain are still being studied, but there is no question that it’s real, and often immobilizing. So it is newsworthy that a recent study found that knee pain may be behind all sorts of related complaints too:

“We found that the severity of knee pain and having pain present in both knees were significant risk factors for the development of widespread pain. In contrast, having only structural changes on X-ray indicative of knee osteoarthritis was not.”

Needless to say, “widespread pain’ is exactly what you think it is. Treating the source of referred pain can often resolve its offshoots downstream, as it were, so knee pain doctors such as myself are always looking for new ways to rip this problem out by the roots through careful knee treatment and knee surgery.