Skin heals from cuts, bones from breaks, and hair and fingernails can grow back.  Imagine if everything we lose, tear, or damage could regenerate. If it were possible, we could restore brain cells, tissue, cartilage, or even limbs. While we’re not quite there with natural regrowth of certain functions, scientists have found a way regenerate meniscus in sheep using human growth factors.
Menisci are pieces of cartilage found on the inner and outer edges of the knee that steady the knee and also work as shock absorbers.  Although rubbery and strong, meniscus tears can happen to anyone that suddenly changes direction while running or walking, such as basketball players. This common knee injury is extremely painful and meniscus repair more often than not requires knee arthroscopy. The loss of menisci can lead to degenerative arthritis.
At Columbia University Medical Center, doctors have found a way to repair and replace the meniscus using a 3-D printed implant. These implants are individualized for each patient, and the infusion of human growth factors in the implant spurs on meniscal regeneration. Growth factors are steroid hormones, or proteins that occur naturally in the body. They regulate and stimulate cell growth, and promote healing.
The idea of regenerating menisci is a grand one, as over one million surgeries on the meniscus are performed each year in the United States alone. Jeremy Mao, DDS, PhD, an Edwin S. Robison Professor of Dentistry at the Medical Center where the 3-D prints implants were first trialed, uses a 3-D printer to accomplish the task. He scans the “good” (undamaged) knee using an MRI. These scans are converted to 3-D image, where it is used to make a scaffold (implant) of the meniscus. This procedure, which takes about 30 minutes, is proceeded by the infusion of two human growth factors to form the tissue used in the implant.
Once implanted, it takes four to six weeks for the meniscus to regenerate in sheep. Eleven sheep were used in this trial as their knees are most comparable to humans. Within three months of the implants, the sheep were walking normally, and results postmortem of the meniscus showed the regenerated meniscus similar to naturally formed meniscus.
At the moment, a torn meniscus can be sewn together if small, but large tears require orthopedic surgery to be removed. Occasionally the meniscus can be replaced with meniscus taken from cadavers, or tissue from a part of the patient’s body, but the success rate is quite low for this procedure, and the risks of using tissue from other areas is risky. Removing the torn menisci offers pain relief and decreases swelling to the knee, but the lack of meniscus as a shock absorber will most likely cause arthritis in the future.
This study is valuable for orthopedists and those involved in sports medicine as a new and better way to treat athletes and patients with knee injuries. Talk to your orthopedist about the future of meniscus regeneration.
If you have knee pain or have been told you are in need of an arthroscopy, contact our renowned sports medicine specialists at Orthopedic Surgery San Diego for an evaluation.

FACTORS WHICH INCREASE THE CHANCES OF DEVELOPING KNEE OSTEOARTHRITIS.
 Can ing determine your arthritis risk?
Would you want to know whether your genes put you at a high risk for developing knee osteoarthritis, especially because of your family history, where you might first-hand have witnessed the suffering of someone close to you?
The pain from knee arthritis is devastating and can severely limit mobility. The knees are possibly the most important joints in the body, as they have to support the entire bodyweight day in and day out. Constant knee pain has to be medically checked or knee osteoarthritis could develop which might result in a total knee replacement to obtain relief.
Heredity does play a part in arthritis, but this is not always the case. If there is osteoarthritis in your family, it does not necessarily mean that you will inherit the problem. Arthritis is not the typical type of inherited genetic disease like haemophilia or cystic fibrosis.
Is there a specific test I can take?
You can ask your doctor to sign you up for a DNA test if you have a close family member who suffers from arthritis or . The results will give a broad result as to whether or not you are at risk from a genetic reason.
However, a negative result does not mean you will not eventually have swollen, painful knees that make it a struggle to move or get out of bed in the morning! Likewise a positive report stating that you have predisposing genetic factors for developing arthritis, does not mean that you will inevitably have knee pain, knee arthritis and a possible knee replacement.
Besides genetic reasons, there several other aspects which could determine whether someone is likely to develop arthritis.
Can I prevent arthritis developing?
Regardless of your family history or genes, there are steps you can implement which can substantially lower your arthritis risk.

• Overweight and obesity. Excess weight contributes to both the onset and progression of knee osteoarthritis. Make an effort to shed the excess weight you may be carrying.
• Joint injuries, mainly from sporting activities or a fall. If you constantly, or even just occasionally, suffer knee pain from these issues, visit your medical practitioner to prevent more serious problems later in life.
• Cultivate good lifestyle habits. Quit smoking if you want to keep walking! Eliminate as many acidic foods as you can from your diet, and keep exercising.

Research information.
Like most diseases, arthritis and osteoarthritis have genetic components. Research is ongoing, and recent findings about genes contributing to the various forms of arthritis are leading to new treatment options to reduce pain as well as possibly prevent the onset of this crippling disease.
There is a universal hope that a future simple test will encourage people to make lifestyle changes like losing weight to help prevent the onset of arthritis.
If you are in anyway concerned about your chances of developing arthritis, visit us at Orthopedic Surgery San Diego. And institute some lifestyle changes!  Our specialists are dedicated to providing you the best orthopedic care available

Missouri senior wide receiver Jimmie Hunt underwent surgery Wednesday to repair a torn ligament in the acromioclavicular AC joint in his left shoulder that will force him to miss the Buffalo Wild Wings Citrus Bowl on Jan. 1 against Minnesota in Orlando, Florida.
Hunt had been in constant “day-to-day” dialogue with doctors over the past few days, but they deemed that the pain was too much for him to play through.
The AC joint is located at the meeting point of the acromion and clavicle bones in the shoulder area, which is often specified with a visible bump in the region. Injuries to the area often occur to due a fall or other trauma, which may force the acromion to move or become separated from the clavicle, or cause the ligaments to be stretched or torn.
In terms of Hunt’s injury, he tore the ligament in his left AC joint. In many situations the professional athlete can avert surgery by undergoing physical therapy and receiving other treatment, but it is often too painful of an injury to play through. For Hunt, the injury was determined to be too much shoulder pain for him to continue to play this season.
In the cases where the players are able to play through the pain, the ligament tear is confirmed with an MRI or CAT scan that helps determine the extent of the injury. This is important part in figuring out the type of treatment and therapy needed depending on the severity of the injury.
That said, the best way to manage a AC joint ligament tear is through shoulder arthroscopy because of how deep the structure is in the shoulder. An experienced surgeon and anesthesia are needed to do this operative procedure.
If the player can play through it, they will wear a protective shoulder brace or harness that is secured to their body or pads with tape. This helps keep the shoulder protected within a limited range of motion. This combined with taking anti-inflammatory medication to help reduce the swelling and pain in the shoulder during practices and games helps make playing a possibility.
However, if the pain does increase even with these precautionary measures, the player is recommended to stop playing in order to allow the injury to fully heal. Often times, surgery may still be an option at that point in time.
For Hunt, he chose to go the safe route by taking care of the issue all together by electing to undergo surgery. The recovery process is said to take at least four to six weeks for the labrum to reattach itself, and about another four-to-six weeks for it to get stronger.
It will be a grueling recovery process for the senior receiver, but the decision to undergo surgery will be beneficial for him in the long term for his playing career.
If you suffer from shoulder pain, contact our sports medicine specialists at Orthopedic Surgery San Diego for an appointment.
Jimmie Hunt Photo Credit: David Richard AP
Shoulder Labrum Photo Credit: Kansas City Bone & Joint Clinic

Cryptic Virus To Potentially Cripple and  in Children; Studies Ongoing

In what must have been a 21^st century version of polio scare, parents and hospitals became frantic as children across different regions of U.S. started having difficulty of breathing, moving, swallowing, and in worst cases, speaking. The manifestations of the said infection are very much similar with polio but the culprit is different. As of now, vaccines are not available and ongoing studies are being conducted to establish association and causation. Doctors hope that in an expected outbreak in 6 months, they will be able to discover a treatment to handle a potential epidemic.
This mysterious virus is called Enterovirus D-68 (EV D-68). The paralysis is referred as Acute Flaccid Myelitis. According to pediatric neurologists, the paralysis that caused orthopaedic complications closely resemble as that of polio’s. It started with vague manifestations experienced by a child such as colds, stomach upset, fever, and headache. Then, neck pain appeared which is believed to be meningitis as a complication. Weeks after, paralysis developed. Encephalitis, as such, is a fatal complication.
Outbreak in pediatric patients lost at least 12 lives and presented with higher than expected number of hospitalizations that posed a challenge to hospitals’ bed capacity. Hence, U.S. Centers for Disease Control and Prevention (CDC) acknowledged it as one of its ‘most challenging public health threats’. Because the pathology of the disease is currently not well-established, CDC took a leap to expect the worst by correlating it with polio. Before polio vaccines were established on 1979, polio crippled and killed thousands of lives. Others survived but with serious orthopedic complications.
However, CDC is considering also the possibility that Acute Flaccid Myelitis is an entirely different infection in pediatric clients. According to Mark Pallansch, Director of CDC Viral Disease Division, they are now currently reviewing cases to come up with its epidemiological trends. This is to determine possible associations between certain factors in children and the infection.
Numerous studies are being conducted now. Sam Dominguez, a pediatric infectious disease specialist at Children’s Hospital in Colorado expressed concern about the possibility of the disease returning next summer. As a response, doctors are using a study conducted by Mary Anne Jackson of Children’s Mercy Hospitals and Clinics in Kansas City, Missouri to predict whether enterovirus will return next summer. Antibody tests against EV D-68 were conducted to various people from babies up to 65 years old to rule out the tricky pattern of the disease. The disease was observed to be occurring in tiny minority of children. It was found out that only people above 40 years old have the antibody. This makes an interpretation that if ever the infection will return, it won’t be as prevalent as it is this year.
Meanwhile, it is recommended that the public be extra vigilant to each child’s manifestation. It is important that caregivers should not ignore something as simple as fever. The public should teach children proper hygiene and ensure that it is being properly maintained. The infection under study is grave enough to cripple children. It is vicious enough to steal children’s ability to walk and that is something we would not want children to suffer.

Improved Diagnostic Criteria for Measuring Intramuscular Compartment Pressure in Chronic Exertional Compartment Syndrome Chronic Exertional Compartment Syndrome (CECS) is a condition in which nerves and muscles are damaged therefore causing pain. The most common affected area is the lower leg. If not managed promptly, it can lead to disability of the affected muscle. It is primarily induced by exercise or any repetitive strenuous body movement. It is most common in athletes although anyone can develop Chronic Exertional Compartment Syndrome (CECS) . Signs and symptoms include cramping pain (leg pain is the most common), weakness, numbness, and tightness of the affected limb. Patients suffering from unusual pain that is not relieved by ordinary measures for pain management during exercise are automatically advised to see a doctor. It is diagnosed through measurement of intramuscular compartment pressure (IMCP). It is currently the mainstay treatment. Basically, it involves insertion of needles into the muscles. However, there seems to be a debate among orthopedists whether the existing diagnostic criteria is the best method possible and if it is accurate, specific, and sensitive. Therefore, a study entitled “Intramuscular Compartment Pressure Measurement in Chronic Exertional Compartment Syndrome: New and Improved Diagnostic Criteria” was conducted in United Kingdom led by David Roscoe, MRCGP, MFSEM. The study was published on November 18, 2014 in The American Journal of Sports Medicine. The study used cohort design to compare dynamic IMCP measurement and anthropometric factors between symptomatic and asymptomatic patients with Chronic Exertional Compartment Syndrome (CECS) . This is also to establish the efficiency of the existing criteria of diagnosing which is Pedowitz criterion. The new method under study was compared to the existing diagnostic criteria, the major difference of which is the timing of measurement while participants are exercising. Participants included in the study where trauma patients who are males ranging from ages 21 to 40. These participants have either leg injury or tibia fracture. Participants with diagnoses other than Chronic Exertional Compartment Syndrome (CECS)  were excluded in the study. The number of participants was divided equally into two groups: symptomatic CECS patients and asymptomatic Chronic Exertional Compartment Syndrome (CECS) patients. IMCP was measured continuously before, during, and after participants exercised on a treadmill, carrying a 15-kg load while they are on it. On the other hand, using Pedowitz criteria, IMCP was measured one minute and five minutes after , respectively. Consistently observed in the study was the significant difference in the pain experienced between control group and the subjects (subjected to 23.8 mmHg pressure for controls and 35.5 mmHg for subjects). The peak of difference was observed on the maximal tolerable pain (68.7 mmHg for controls vs 114 mmHg for subjects). This means that diagnosis can be improved when pain is measured continuously and not just one minute and five minutes after exercise as currently being utilized now. The improved diagnostic value is 63% more sensitive and 95% more specific than the existing diagnostic criteria. On the other hand, it was found out that the Phase 2 of the new and improved diagnostic criteria utilization is more accurate than Pedowitz criteria. Since Chronic Exertional Compartment Syndrome (CECS) can always be mistaken for shin splints, a less serious cause of leg pain related to exercise; an improvement should be established in the diagnostic criteria to provide early detection of the condition. If not detected early, CECS can result to loss of function of the affected limb. If you have leg pain, contact our sports medicine specialists for an evaluation at Orthopedic Surgery San Diego.

Osteoarthritis (OA) is the most common form of arthritis affecting the weight-bearing joints and is suffered by millions of people worldwide. Due to continuous use of these joints, cartilage wears out and the friction between bones causes heat and pain. This is disabling and can significantly reduce the quality of life of a person suffering from it. The most commonly affected part is the knee. Signs and symptoms suggesting OA include pain related to movement, tenderness, and stiffness of the joints upon waking up. Patients with stiffness lasting for unusually longer duration should see the doctor.
Knee OA can increase the risk for knee injury if OA is not managed promptly. Although it has no cure, exercise, healthy weight, and control injections of hyaluronic acid (HA) or normal saline solution (NS) can help slow down the progression of disease. Severe and uncontrollable signs and symptoms may lead to loss of function of the knee and is strongly suggestive of indication of knee replacement. However, if manifestations are not strongly indicative of knee OA, doctors may perform knee arthroplasty to differentiate it with gouty arthritis (GA).
Therefore, Dr. Amir Khoshbin’s team from Ontario, Canada conducted a study entitled, “The Efficacy of Platelet-Rich Plasma in the Treatment of Symptomatic Knee Osteoarthritis: A Systematic Review With Quantitative Synthesis”. The purpose of the study was to conduct a synthesis of all available literature about efficacy of platelet-rich plasma (PRP) in managing knee OA compared to control injections. This was done by conducting systematic reviews of all available high-quality published randomized controlled trials (RCT) and prospective cohort studies evaluating efficacy ofplatelet-rich plasma (PRP) versus control injections of HA and NS for knee OA from Medline, Embase, Cochrane Central Register of Controlled Trials, PubMed, and clinicaltrials.gov. Reviews were done independently and differences were settled through discussions. The study was published in Arthroscopy: The Journal of Arthroscopic and Related Surgery on December 2013.
Participants included in the study totalled to 577 patients. 264 (45.8%) were assigned to the treatment group (subjected to PRP) and 313 patients were assigned to the control group (received control injections in the form of HA and NS).
After 24 weeks, therapeutic effect of platelet-rich plasma (PRP) vs. control injection was measured through the following outcome measurements: Western Ontario and McMaster Universities Arthritis Index (WOMAC) , visual analog scale for pain (VAS), International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), and overall patient satisfaction. Patients receiving platelet-rich plasma (PRP) were observed to have higher WOMAC and IKDC scores reflecting PRP’s superiority from HA and NS.
However, there was no significant difference between VAS scores and patients’ satisfaction of the control and treatment group. This may be attributed to the participants’ heterogeneity and limited number. Researchers suggested increasing the number of participants. No adverse events were reported in both studies. In the study, it was specifically discovered that a series of 2-4 injections of platelet-rich plasma (PRP) at a minimum of 24 weeks improved the functionality of the joints as evidenced by higher WOMAC and IKDC scores.
Overall, using platelet-rich plasma (PRP) injections can have beneficial effects for treating mild to moderate OA in about 6 months. This is another leap in the advancement of sports medicine.
If you have knee pain, contact our sports medicine specialists at Orthopedic Surgery San Diego for an evaluation.

Bone Breaks

Cuts, falls, sprains, pediatric injuries, and the occasional boo-boo (that doesn’t really need a Band-Aid, but we put one on anyway) are all part of growing up. Bone Breaks, while less common, are traumatic to say the least, for both the child and the parent. The casts, the pain, and the six to eight weeks of misery is nothing to celebrate, but luckily, children’s bones heal quicker than we think. The scariest kind of break, an open bone breaks , where the bone actually protrudes through the skin is a heart stopper for most parents, and the first thing we think is “surgery”. Fortunately, there are open bone breaks that can actually heal without the need for orthopedic surgery, especially under the guidance of a doctor skilled in sports medicine and pediatric orthopedics.
The tendency to automatically perform surgery on pediatric injuries, such as a wrist fracture, knee injury, broken arm or leg, or wrist injury, prevails, even though, a “watch and wait” approach could be just as beneficial, if not more so.  Salter-Harris Fractures, which are fractures in the growth plates along the long bones of the fingers, outer forearm, and lower leg bones, can be healed without surgery.
Because of the debate between doctors regarding “to surgery or not to surgery” a study was conducted to determine the need. A retrospective analysis was taken of forty patients that had open type I pediatric fractures to the forearm or tibia. These patients were between the ages of 4 and 16 that had been treated without surgery at John Hopkins between the years of 2000 and 2013.  Each patient was casted under conscious sedation and discharged the day of the injury. The results of the study showed that if the open bone breaks wound was small, as in less than ½ inch in diameter, and the tissue surrounding the wound was free of debris, the wound could heal without surgical intervention. There was no sign of infection in any of the forty patients that were surveyed for this study.
It would seem logical that a wound that small could heal on its own rather than need surgery, but not all wounds are the same. The same size wound on one child could still result in surgery if the surrounding tissue was damaged or contaminated, but it is possible to heal surgery free for many open bone breaks. The senior study investigator, Paul Sponseller, M.D. feels that these results may give way to proving the idea of non-surgical approaches to many types of open bone breaks.
The benefits to allowing the bone to heal on its own are numerous:

–          No anesthesia
–          Less scarring
–          Easier/faster recovery
–          Less cost
–          Less trauma

As scary as it seems to see your child with an open bone breaks, keep in mind that surgery is not always inevitable. Ask questions of your child’s doctor to see if surgery is a necessity before it occurs.
Schedule an appointment with our pediatric sports medicine specialists at Orthopedic Surgery San Diego.  Our specialists strive to offer you the best surgical and nonsurgical options.

Study Shows Lyrica Ineffective in Spinal Stenosis

It might be surprising to know that we can be prescribed medicine to counteract an ailment that the drug itself wasn’t actually designed to treat. This is called “off label prescribing” and has been done in about one in every five prescriptions.  For example, Cartia, a calcium channel blocker, usually used to treat hypertension and angina, is a very effective medication for those suffering from Raynaud’s disease. Diphenhydramine, also known as Benedryl, while an approved antihistamine drug, has been prescribed as a sleep aid due to its effects. Topamax, a medicine used to combat seizures is now a commonly prescribed migraine prevention medication. Lyrica, also known as pregbalin, has also been prescribed to many patients for the treatment of back pain and chronic pain. Lyrica has been shown to be an effective remedy for anxiety, even though it is FDA approved for fibromyalgia, epilepsy, pain from shingles, and seizures. This medication binds to the nerves which is thought to essentially block pain signals from one nerve to another, decreasing pain. It has been found, however, in a recent study, that although prescribed for back pain, Lyrica is not effective with a common case of back pain, known as spinal stenosis. The study was conducted on 29 people all over the age of 50 with severe lumbar spinal stenosis. This condition happens when arthritis or other issues cause the ligaments in the lower back to thicken and the canal where the spinal nerves travel becomes narrow. This causes the nerves to be “pinched” which is felt as a tingling and burning sensation in the legs or buttocks. Steroid injections are used to decrease the inflammation, and surgery is occasionally necessary to open the narrowed canal. The study of the effectiveness of Lyrica was conducted on these patients specifically because chronic lower back pain is more common than nerve pain. Those in the study were either given Lyrica or an antihistamine placebo, and neither group saw any more improvement over the other. Because this was only one study on a small amount of people, it is doubtful it will affect the number of prescriptions written for back pain.Back pain happens to everyone at some point in their lives, be it from active or sedentary lifestyles, sports, injuries, or lifting something incorrectly. Age is also a factor in back pain as the spine degenerates over time, making us more prone to pain and injury the older we become.

Orthopedists often see patients complaining about back pain, which can range from mild and sporadic to excruciating. Different remedies are prescribed based on the location of the injury and the type of pain. Many back issues correct themselves after a few weeks, but chronic conditions and more severe issues need a sports medicine specialist, or orthopedist to get the patient back on track. If you have back pain, the staff at San Diego Orthopedic Surgery is committed to getting you the help and treatment you need and deserve. Our specialists provide the best orthopedic and medical care available.

The Role Platelet-Rich Plasma Plays In Anterior Cruciate Ligament Allograft (ACL) Healing

An allograft refers to a bone or soft tissue transplanted from a person to another. Normally, allografts, also known as donor tissues, are more preferable than autografts (a person’s own tissue) for various reasons. Allografts are helpful in assisting patients to regain mobility, reinstate function so that they can enjoy better life.
Allografts tend to retain vital biologic and biomechanical characteristics which enable not only quicker but also greater healing.
The Anterior cruciate ligament, which is abbreviated as ACL, is the smallest but the most important of the four knee ligaments that stabilize the leg when a person twists the body. It runs diagonally through the inside of the knee and is crucial in giving stability to the knee joint. It is also helpful in controlling the lower leg’s back-and-forth movement. Injuries to the ACL can arise in a few circumstances as well as sports and can be severe. Surgery may thus become a must.
Torn ACLs are a common knee injury and statistics show that more than 200,000 injuries occur each year in the U.S with nearly 100,000 ACL repair surgeries being performed every year.
An ACL tear or sprain happens the moment there is a sudden change in direction or when pivot occurs on a locked knee. The most common symptoms of an ACL tear are a pop, followed by pain and swelling. Women are said to be more prone to tear their ACL owing to their differences in anatomy as well as muscle function.
ACL tear treatment focuses on returning the patient to his or her pre-injury level of function. Arthroscopic surgery is usually performed to reconstruct the torn ligament.  A patient can take between 6 to 9 months to return to normal activity following an ACL injury.
If you tear the ACL in your knee, you may have to undergo reconstructive surgery. It is difficult to repair a torn ACL by stitching it back together. However, ACL reconstruction can be done by attaching new tissue (an allograft) onto it. The remainder of the torn ligament is removed and replaced with a tendon from the patellar or hamstring tendon.
Platelet-rich plasma, which is abbreviated as PRP, is blood plasma that has been supplemented with platelets. It consists of a number of growth elements as well as other cytokines that stimulates healing of bone and soft tissue. It is a concentrated source of autologous platelets and normally releases them through degranulation. Platelets regulate healing and tissue regeneration in the body. They are also responsible for blood clotting in order to prevent too much bleeding.
PRP preparations have been used as remedies in several medical fields ranging from implantology to vascular ulcers. There is more recent development and encouraging results in the fields of sports medicine as well as arthroscopy. Certain applications may be contained in PRP which will speed recovery in cases of muscle, tendon, ligament and cartilage disorders. Apart from improved allograft integration, ACL reconstruction has exhibited improved autograft maturation, better donor site morbidity and pain management. Patients may undergo faster and more intensive rehabilitation programs and resume sporting quicker via acceleration of the biological integration of the graft using PRP.
For sports medicine and doctors, the advent of PRP, with its autogeneous nature, the ease with which it can be prepared and its superb safety profile has opened an additional therapeutic door. In future the focus will be on improving the results of arthroscopic together with related surgery. Also, defining right prescription, timing and best techniques PRP use.
If you have been told that you sustained an ACL tear or are interested in finding out more about PRP, contact our sports medicine specialists at Orthopedic Surgery San Diego today.  Our specialists strive to offer you the best surgical and nonsurgical options.

knees

Popping and crackling noises in the knees while squatting or getting out of a chair are rarely symptoms of any injury or medical condition, the New York Times reported in its “Well” blog.
The crunching or grinding sensation, known as crepitus, sometimes results from gas bubbles popping in the knees. If there is no pain or inflammation, medical treatment is not needed, according to Dr. Michael Stuart, professor of orthopedic surgery and co-director of sports medicine at the Mayo Clinic.
In some cases, cartilage damage or meniscus tears cause crepitus. When cartilage in a knee deteriorates, the joint’s bones and tissues are no longer protected. They rub against one another, triggering inflammation and potentially leading to osteoarthritis. If left untreated, the pain and impaired mobility can reach the point that knee replacement (arthroscopy) becomes necessary.
“Crepitus is extremely common,” Stuart told the Times. “Our joints make a lot of noise.” He explained that, in addition to pain and swelling, a locking of the knees is a sign that treatment might be needed. Meniscus tears cause “mechanical symptoms like catching or locking,” he said.
Crunching or grinding sounds heard while squatting sometimes are indications of osteoarthritis. However, in the absence of inflammation and other discomfort, the sounds “may be innocuous,” according to Stuart.
He noted that deep squats, involving the hips dropping lower than the knees, put excessive strain on the knees. To prevent cartilage injury, it is advisable to exercise with more moderate squatting.
“When you perform a full squat, you put almost eight times your body weight across your knee cap,” Stuart told the Times. “Then, when you add a barbell or load on top of that, it ends up being very, very high forces to the joints and tissues around the knee.”
The noises associated with crepitus result from “an abnormal interaction (among) air, fluid or bone … when rough surfaces in a joint rub together,” according to healthgrades.com.
“Crepitus can be due to a wide variety of conditions, and associated symptoms can also vary widely,” the website reported. “Soft-tissue crepitus, due to air inside body tissues, is a serious type. Crepitus due to arthritis or joint problems can be a sign of chronic disease or joint damage.”
Symptoms of crepitus include joint pain, inflammation, stiffness that is more severe in the morning, skin warmth and redness, and reduced mobility. Healthgrades.com noted that signs of potentially life-threatening conditions are “bluish discoloration of the skin or lips, chest pain or pressure, confusion or loss of consciousness for even a brief moment, difficulty breathing, fever higher than 101 degrees Fahrenheit, nausea and vomiting.”
Subcutaneous crepitus, which occurs in soft tissues under the skin, requires immediate medical attention because it can be a symptom of a bacterial infection, wound or collapsed lung.
If you are experiencing crepitus associated with pain in your knees, schedule an appointment for an evaluation by the sports medicine surgeons at Orthopedic Surgery San Diego. They can diagnose the cause of the discomfort, whether it is knee osteoarthritis, a meniscus tear, cartilage injury or another condition. You can learn all your options, including knee replacement (also known as knee arthroplasty).  Our specialists strive to offer you the best surgical and nonsurgical options.