Stem cell

The bones inside the human body often require active mechanical stimulation from the outside to be able to maintain their functions, and also to form new tissues. Sadly, not many therapies include mechanical stimuli in their treatment programs for the healing and regeneration of bones. One of the current therapeutic measures, which provides such dynamic mechanical stimuli for improved bone health is stem cell therapy for knee osteoarthritis. The pioneering field of stem cell therapy mainly aims at creating novel treatments for disorders that have limited or no treatment at all.

Stem cell research has been taking science and medicine to previously unknown vistas, one of which is the use of stem cells for knee pain and knee osteoarthritis. In fact, recent advances in stem cell and PRP or platelet rich plasma injections have led to better and improved measures for the treatment of bone damage in osteoarthritis and other bone diseases. Interestingly, stem cell therapy has the ability to replace or restore the functions of various tissues, cells, and bones to encourage normalcy in the various functions of one’s body. No wonder, stem cell therapy is proving to be extremely useful in the treatment of previously incurable bone diseases such as knee osteoarthritis.
Stem cell therapy for bone regeneration:

The mechanical stimuli in this therapy are delivered through magnetic nanoparticles. These nanoparticles are attached to the human mesenchymal stem cells before being injected into the bone to bring about regeneration. The stem cells are likely to increase the bone mineralization by almost 2.4 folds and increase the matrix density inside the bones too. These cells are also known to work positively in repairing and regenerating tissues of the bones, cartilage, muscles, and tendons alike. This ability of the stem cells to maximize bone formation is the major reason for their successful integration into orthopedic therapeutic measures.

How does stem cell therapy help knee osteoarthritis?
Although, knee pain often appears ordinary and inconsequential on the outside, the actual story within the knee joint is usually quite the opposite. Knee osteoarthritis typically results from degenerative changes to the bones within the knee joint.

These degenerative changes are likely to damage and weaken the bones, resulting in inflammatory changes in the tissues around them. Usually, the outcome of these changes is a weak and painful knee joint. Hence, knee pain is best taken care of as soon as possible. Unfortunately, the therapies currently in place for knee osteoarthritis and knee pain aren’t very effective in providing a cure for these disorders. At the most, the patient is likely to gain a small amount of relief from knee pain with painkillers and anti-inflammatory medicines. However, stem cell therapy and PRP injections have the capability to enable tissue regeneration in the knee joint and reverse the degenerative changes to provide pain relief and cure for knee osteoarthritis.
Thus, stem cell research isn’t confined only to the laboratories anymore but it’s now entering the medical and therapeutic field to enhance certain areas of treatment for the benefit of longtime sufferers and patients.

knee

DOES YOUR KNEE HURT?

Reasons for knee pain can vary.
If you constantly suffer from knee pain, this could be as a result from a present or previous injury, or a medical reason such as gout or arthritis. Either way, knee pain is debilitating and restrictive to everyday activities. Failure to address the problem could result in long-term problems and possible disability.
What sort of injury or factors can contribute to knee pain?
• Sportsmen participating in vigorous sports such as rugby, tennis, squash, soccer and hockey, as well as runners, are very prone to knee injuries. These injuries include torn cartilage, damaged or torn ligaments, dislocation of the kneecap or perhaps even a broken bone. All or any of these will cause extreme knee pain needing speedy medical intervention.
• Another factor is the issue of overweight and obesity. The stress placed on the knees having to support excessive body weight can lead to permanent joint damage and a lack of mobility which grows worse with time.
• A medical issue will arise from the development of arthritis or osteoarthritis. This condition may be caused by the stress of obesity, old injuries, over use from vigorous sporting activities, or even genetic influences. Left untreated, knee pain will increase as you grow older.

What are the treatment options?
• The most suitable treatment depends on the cause of the pain and the degree to which mobility and function is limited. This will be determined by your doctor after an intensive examination and tests have been done.
• One option would be to embark on a course of conservative, non-surgical treatment such as anti-inflammatory medication, physical therapy and specific exercises.
• If no relief is obtained from the conservative treatment, your doctor may suggest knee surgery to correct the problem and relieve the symptoms.
The knee surgery option.
If it has been recommended that you need knee surgery, the San Diego Orthopedic Surgeon Center is equipped to provide first-rate options for every type of knee condition. Supervised and administered by renowned orthopaedist Dr Robert Afra, we offer minimally invasive knee surgery options from arthroscopic cartilage repair to ligamental reconstruction, resurfacing techniques and partial or total knee replacement.

Before any knee surgery is undertaken, the medical team at the San Diego Orthopedic Surgeon Center will undertake a comprehensive orthopedic assessment to establish the reason for the surgical intervention as well as a preoperative medical clearance to reduce post-operative risks.
We also provide patient education about what to expect during knee surgery, how to manage pain and the best way to move about after the operation.
The San Diego Orthopedic Surgeon Center is focussed on addressing all patient concerns or questions and providing the best treatment to restore your quality of life.
Don’t be overwhelmed by suffering constant knee pain. The San Diego Center can assist you to find permanent relief.

Have you ever hear the phrase “carrying the weight of the world on your shoulders”? While this applies in a more figurative sense to those with large burdens, it still works on a physical level. We are always using our shoulders, and they are the most flexible parts of our body. We use them to stand upright, to lift, push, carry, reach, comb hair, brush teeth, cook, hold our clothes on, clean, work, drive, rest, type, along with giving our heads somewhere to rest. We put our shoulders to the test daily, and occasionally, our activities can cause them pain.
Shoulder pain can be debilitating. What once was an easy task, such as reaching for a shirt in the closet, can be a painful chore when the shoulder is not functioning. Our shoulders are ball and socket joints which allows for the wide range of motion we are used to. Inside the shoulder are bursae which are filled with fluid that allows the shoulder to glide when moving, rather than jerk and twist. Occasionally the bursae can become inflamed, or the muscles can became weak and damaged, effectively ending the ease of movement we once had.

It is important to note that not all shoulder pain is actually caused by the shoulder, however. Sometimes neck pain can manifest itself in the shoulder blade. If your pain is accompanied by numbness and tingling in the hand, this could be caused by bulging discs in the neck.
Degrees of shoulder pain can vary from mild to ferocious. Unless the pain is excruciating, start off with rest at home using NSAIDs and ice on the area. Use your good arm to lift your painful arm, and keep it close to your body as you rest. Keep a pillow behind your lower back to keep your posture correct, and rest the injured area on a pillow. If pain persists or gets worse, call the doctor.
An orthopedic surgeon can help determine the best cause of treatment for shoulder pain.
Because of the complex makeup of the shoulder, there are many types of injuries that can occur. Overuse can cause tendinitis or bursitis, which is usually treated by modifying actions. Rotator cuff tears are common, and the pain can be alleviated with cortisone shots or treatments. The shoulder can “pop” of the socket, which is called a dislocation. This is painful, but can be set back in with an orthopedic surgeon’s help.

If over the counter treatments, therapy, or rest do not help the problem, shoulder surgery may be required. For issues such as repeat dislocations, fully torn rotator cuffs, fractures of the collarbone, and osteoarthritis can often need surgical repair. The orthopedic surgeon always does a full assessment, noting your health history, a physical examination, along with diagnostic images such as an MRI or X-rays to determine the extent of the damage.
San Diego Orthopedic Surgery is committed to helping each and every patient become as pain free as possible.

Treatment for Knee Pain

We take our joints for granted, especially when they’re functioning properly.  We use them to walk, run, stand, sit, jump,cycling, play, and work. Even at rest, we put pressure and weight on our joints. Luckily joints, bones, tendons, and ligaments are pretty resilient and can take a lot of wear and tear. At some point, however, joints can begin to feel the strain of constant use and begin to wear down. Our knees are joints that we use all the time as we bend and straighten our legs throughout the day. Those that are active in sports or just daily activities use their knees to squat, kneel, and bend causing potential damage to the area. When the knees begin to hurt, it doesn’t take long for the rest of the body to feel it, too. When we have knee pain, it is human nature for our body’s to adjust to the pain. We put more pressure on our hips and back and the pain-free leg to compensate. This throws the body out of alignment which can cause aches and pains on its own.Depending on the type of knee pain, over the counter analgesics and NSAIDs can be helpful to reduce swelling and inflammation. The RICE treatment – rest, ice, compression, and elevation – are encouraged to allow the knee to rest and recuperate. Occasionally, a knee brace or Ace bandage can be used for extra support if needed.If the pain does not go away in a few days from this home remedy, and instead, grows worse, it is time to seek out an orthopedic doctor.

Orthopedics is a branch of medicine that deals with the musculoskeletal system, and encompasses a broad range of injuries of the bones, tendons, ligaments, nerves, joints, and muscles. While orthopedists are also knows as doctors of sports medicine, one does not have to be an athlete to seek one out for treatment . Orthopedic surgeons specialize in surgeries and treatment to help everyone regain mobility and function. Treatment for knee pain include cortisone shots, which is administered once and provides relief from 3-6 months, and sometimes years. Viscosupplement injections are given once a week for 3 weeks and provide relief for long periods of time. Platelet Rich plasma (PRP) injections are also a consideration. Knee surgery is a common surgery for an orthopedic surgeon. There are different types of surgeries, both inpatient and outpatient that can get you back on your feet. The most common type of knee surgery is arthroscopic surgery, which involves small incisions being cut into the damaged area followed by a tiny camera inserted inside to allow the doctor to assess the damage. While inside, he can use tools to smooth away rough areas, and remove tissue. For more severe issues of the knee a partial or total knee replacement is a possibility. At San Diego Orthopedic Surgery, we are with you from beginning to end and consider ourselves your partner in the attempt to give you the best care possible.

Glucosamine Does Not Relieve Knee Osteoarthritis

Knee osteoarthritis is a leading cause of pain and disability in middle-aged and elderly adults. Many people who suffer from the disease take dietary supplements of glucosamine and chondroitin, components of cartilage that the body naturally creates to cushion joints.
Some research has indicated that glucosamine and chondroitin, when combined with sulfate, strengthen knee cartilage and reduce the need for nonsteroidal anti-inflammatory medication, according to the Mayo Clinic.
However, data recently published online in the journal ” & Rheumatology” suggests that the supplements are not particularly helpful in relieving knee-osteoarthritis symptoms or preventing them from getting worse.
Shibing Yang, PhD, of the Division of Epidemiology at Virginia Commonwealth University led the study. Researchers analyzed the cases of 1,625 patients. Eighteen percent of them received treatments of glucosamine or chondroitin. Their pain, stiffness, function and joint-space widths were not significantly different than that of patients who did not take the supplements.

“Our data join a growing body of evidence suggesting that glucosamine or chondroitin has no impact on relieving OA symptoms,” the study’s authors concluded. “We found that treatment with glucosamine or chondroitin for three years did not appear to bring about relief in symptoms or retardation of disease progression.”
There is no cure for osteoarthritis, the most common type of arthritis that affects the knee, according to the American Academy of Orthopaedic Surgeons. It is a degenerative condition that advances over the years due to wear and tear. That is why most suffers are 50 years of age or older.
As cartilage in the joint deteriorates, bones begin rubbing on each other. This causes pain and, in some cases, bone spurs that increase the discomfort.

The disease’s major symptoms are pain and inflammation. Patients also report weakness and stiffness that make it hard to bend or straighten the knee. The joint may lock, buckle, creak or click as a result of loose cartilage fragments inhibiting knee movements. Other signs include warmth or redness, tenderness, decreased range of motion, joint instability, crepitus (a grinding sensation), and a narrowing of the space between bones in the knee.
Doctors perform physical examinations, conduct diagnostic tests (like X-rays, CT scans, MRIs and bone scans), and sometimes draw blood samples to determine whether patients have knee osteoarthritis. They must make sure a person does not instead suffer from rheumatoid arthritis or another condition.

Many patients find some relief by altering their physical activities. Doctors recommend low-impact exercises like swimming, rather than jogging and other activities that strain the knees.

Losing weight also takes pressure off the joints. Physical therapy involves exercises designed to strengthen muscles, increase mobility and improve knee function.

Assistive devices such as canes, shock-absorbing shoes or inserts, and knee braces and sleeves can make it easier to walk. Patients also alternately apply ice and heat pads, use pain-relieving ointments and creams, wear elastic bandages, and take corticosteroids or nonsteroidal anti-inflammatory medication.

Visco supplementation is the injection of hyaluronic acid, a naturally occurring substance, into the knee to lubricate bones and enhance the joint’s shock-absorbing ability. Other techniques include acupuncture, the use of needles to relieve pain; and magnetic-pulse therapy, the application of an electromagnetic signal.
When such treatments prove to be insufficient, doctors sometimes suggest surgical solutions. In some cases, symptoms can be treated with an arthroscopic procedure, a minimally invasive operation in which tiny cameras and instruments are inserted into the knee through small incisions.

Other types of surgery are grafting, in which healthy cartilage is transplanted from another part of the knee or a tissue bank; and osteotomy, the cutting and reshaping of the tibia (shin bone) or femur (thigh bone) to reduce pressure on the joint.

In more serious cases, total or partial knee replacement (also known as arthroplasty) may be recommended. The surgeon removes damaged cartilage and bone, and implants metal or plastic prosthetic devices.
If you suffer from knee pain, stiffness and impaired mobility, it is important to get a diagnosis and begin treatment before the symptoms worsen. Schedule an appointment for an evaluation by the nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego to learn how to relieve the discomfort and regain full use of your knees.

Arthritis in the knee and hip is a leading cause of pain and disability, particularly for older people. Doctors sometimes recommend replacement of the joints with prosthetic devices. They advise patients to drop some pounds before undergoing the surgical procedure.
Weight control can be challenging. The federal government recently announced new regulations, to take effect in late 2015, that might help people monitor their dietary habits. Calorie information will be required on food menus at restaurants, grocery stores, coffee shops and other establishments. The Food and Drug Administration’s new rules will even apply to movie theaters and vending machines, the Washington Post reported.
“Americans eat and drink about one-third of their calories away from home, and people today expect clear information about the products they consume,” said FDA Commissioner Margaret A. Hamburg. She explained that the new regulations will make it easier to make healthy choices.
The Post noted that, for years, advocates of “transparency” in food labeling have been urging government officials to enact such regulations.
“I consider this an enormous advance for public-health education and well worth the long wait,” Marion Nestle, a nutrition expert and professor at New York University, told the newspaper. “This is great news for public health and, hopefully, an incentive to restaurants to reformulate their offerings to be lower in calories.”
The calorie-listing requirement is a provision of the Affordable Care Act, the 2010 law also known as Obamacare. It took four years for the government to draft the rules, as consumer organizations pushed for stringent regulations and industry groups lobbied against any mandates.
The debate resulted in a plan to apply the calorie-posting requirement only to restaurant chains with 20 or more locations. Daily specials, seasonal foods and mixed drinks are among exempted items, according to the Post.
Pain resulting from arthritis in the knee and hip often can be treated without surgery. Many people relieve their discomfort and improve function in their joints by taking anti-inflammatory medication and receiving physical therapy. Exercises are designed to strengthen muscles and improve range of motion.
When such treatments fail to provide relief, full or partial replacement of a knee and hip may be needed to restore full function. In 2011, nearly a million people received knee and hip replacements in the United States. Also known as arthroplasty, it is one of the most common musculoskeletal surgical procedures, according to the American Academy of Orthopaedic Surgeons (AAOS).
Doctors generally advise obese or overweight patients to shed some pounds before having the operation. Excess weight increases the risks of surgery, and places too much stress on reconstructed joints, the AAOS explained.
Weeks or months before having surgery, it’s a good idea to engage in a weight-loss program featuring a nutritious diet rich in fruits and vegetables. Regular exercise and reduced alcohol consumption also are recommended.
If you are experiencing knee and hip pain due to arthritis, schedule an appointment for an evaluation by the nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego to learn about ways to relieve the discomfort and regain full use of your joints.

About 200,000 people suffer sports-related concussions in the United States annually. Some of them recover quickly, while others experience persistent problems and even brain dysfunction.
A recent study by Penn Medicine, published in the Journal of Neurotrauma, linked the severity of post-concussion symptoms to a brain-enriched protein called SNTF. Scientists confirmed previous evidence that patients with greater amounts of the protein are more likely to develop conditions like diffuse axonal injury and long-term cognitive dysfunction.
“We extended this biomarker research to the domain of professional sports to test its merit as an objective and rapid way to determine players’ severity of brain injury,” said lead author Robert Siman, PhD, research professor of neurosurgery at Penn. “This blood test may aid neurobiologically informed decisions on suitability for return to play following a sports-related concussion.”
The research involved 288 Swedish professional ice-hockey players, 28 of whom had sustained concussions during the 2012-13 season. The injury victims’ blood was analyzed daily to evaluate the degree to which their symptoms were subsiding. Eight of them no longer had symptoms a few days after their injuries. The other 20 players reported ongoing problems that kept them out of competition for at least six days.
The scientists discovered that those 20 study participants experienced increases in SNTF levels between one hour following their injuries and 144 hours later.
“These results show that SNTF has promise as a blood biomarker for sports-related concussion and beyond,” wrote Siman and senior author Douglas H. Smith, MD and director of Penn’s Center for Brain Injury and Repair.
Their report continued: “High blood levels of SNTF appear to identify acute brain damage that corresponds with persisting symptoms after concussion. These observations lend further support to the growing awareness that concussion is not trivial, since it can induce permanent brain damage in some individuals.”
Identifying concussion symptoms and initiating appropriate treatment is particularly crucial for children and teenagers who play sports. They usually take longer than adults to recover, according to the American Academy of Orthopaedic Surgeons (AAOS).
The injury hampers the brain’s ability to function and process information. It can affect balance, coordination, memory and speech. Athletes who have had one concussion are prone to suffering more such injuries. Recurring incidents can cause long-term disability.
Brain

The damage results from a sudden, high-impact force to the skull, which violently shakes the brain. Either a blow to the head, or an impact to another part of the body that makes the head snap, can cause a concussion. The injuries happen for a variety of reasons, but people who play sports are among those at the greatest risk. Football, ice hockey and soccer have some of the highest concussion rates.
The symptoms of this brain injury can be hard to recognize immediately following an accident. In some cases, the signs do not appear until days later. A concussion can result in physical, cognitive and emotional issues. According to the AAOS, the most common symptoms are drowsiness, headache, loss of consciousness, memory loss, irritability, confusion, balance problems, dizziness, difficulty speaking and communicating, depression, nausea and vomiting, and altered sleep patterns.
If you or your child suffers a concussion, an immediate evaluation by medical professionals is critical. The nationally renowned sports medicine staff at Orthopedic Surgery San Diego can assess your symptoms and recommend the best treatments.

Athletes know that good nutrition is necessary to gain the most benefits from exercise and protect the body from injury. However, recent sports medicine research indicates that taking supplements of vitamin C and E is less effective than getting the nutrients from food sources.
The New York Times reported that “antioxidant vitamin are enormously popular with people who exercise.” However, the newspaper noted in its “Well” blog, the supplements “might be counterproductive to certain types of exercise, including running and other endurance sports.”
Research by scientists at the Norwegian School of Sports Sciences, published in November in The Journal of Physiology, found that athletes who took vitamin C and E pills got bigger muscles, but gained less strength, than those in the control group.
“Aerobic exercise and strength training lead to the production of free radicals, molecules that in concentrated amounts can cause tissue damage,” the Times explained. “Antioxidants sop up and neutralize free radicals. So, the thinking goes, taking antioxidant should lessen some of the damage and soreness after exercise and allow people to train harder.”
To test the theory, researchers gave large doses of the vitamin to endurance athletes. The outcome was “a slightly smaller training response,” according to the Times. The volunteers had lower levels of the enzymes that encourage production of mitochondria in muscle cells, which creates cellular energy. Without sufficient amounts of that energy, a person cannot exercise as intensely or for as long.
The 32 participants in the Norwegian study were weight trainers, rather than endurance athletes like runners and cyclists. The activities involve different biochemical processes in the muscles. Half of the volunteers took vitamin C and E pills before and after their resistance training each day. The others consumed no supplements.
The experiment continued for 10 weeks, with weights being gradually increased. After five weeks, and at the end of the study, the scientists took muscle-tissue samples to measure muscle size and strength. They found that muscles had grown about the same for members of both groups.But those who took antioxidants gained less strength, and “had reduced levels of substances known to initiate protein synthesis,” the Times reported. The synthesis is crucial to the repair and strengthening of muscles after weight training.
As a result of their research, Dr. Goran Paulsen and his colleagues recommended that neither joggers nor weight trainers should take high dosages of the pills.
The scientists wrote: “Vitamin C and E supplementation interfered with the acute cellular response to heavy-load resistance exercise and demonstrated tentative long-term negative effects on adaptation to strength training.”
The findings do not mean that athletes should neglect their nutritional needs (Prednisone). Experts advise them to eat balanced diets featuring plenty of vegetables and fruits, as well as whole grains and protein. Substances these items contain (like thiamin, riboflavin and niacin) enable the body to convert food into energy. Athletes also need to replenish the potassium, iron and calcium that are lost during exercise.
Eating fish twice a week is recommended because omega-3 fatty acids regulate inflammation and stabilize blood sugar. Magnesium (found in leafy greens, nuts, beans and dark chocolate) strengthens muscles and regulates heart rhythm.
Nutrition is important for athletes because it determines how much they get out of exercise. Consuming vital nutrients also empowers the body to resist injury. To learn more, and to find out how you can improve the value of your workouts, schedule an appointment for an evaluation by the nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego.

shoulder pain

Millions of Americans suffer from shoulder pain, due to injuries or other causes. When physical therapy and medication fail to relieve the discomfort and restore shoulder function, surgery is often recommended.
At Orthopedic Surgery San Diego, patients are evaluated to determine their best options. Types of shoulder operations include closed procedures and arthroscopic surgery.The shoulder consists of several joints, as well as tendons and muscles, that allow a variety of movements. The joint features three bones: the humerus, in the upper arm; the scapula, also known as the shoulder blade; and the clavicle, or collarbone. The humerus extends into the glenoid, a socket in the scapula. The muscles and tendons that hold the humerus in place make up the rotator cuff.
Some people feel pain only when they make certain movements, while others experience discomfort even while the shoulder is not being used. Sometimes, the joint heals and the pain goes away. In other cases, patients must obtain treatment to find relief.
The major reasons for shoulder pain are tendon inflammation due to bursitis or tendonitis, tendon tears (most common being the rotator cuff), instability, arthritis and broken bones (fractures). Less common causes include tumors, infections and nerve problems, according to the American Academy of Orthopaedic Surgeons.
Overuse of the shoulder, which occurs while playing sports or performing certain physical tasks, can lead to inflammation of the bursae (sacs of fluid that cushion the bones and tissues in joints). This condition is diagnosed as bursitis.
When the swelling is between the rotator cuff and the acromion (the top of the shoulder blade), it is classified as subacromial bursitis. This frequently afflicts people who also have rotator-cuff tendonitis, which results from long-term deterioration of a tendon.
Tendonitis is either acute, due to an injury from excessive throwing or other overhead activities; or chronic, a degenerative disease that gets worse with age. Most of the time, shoulder tendonitis occurs in one of the four rotator-cuff tendons or in a biceps tendon.
A tendon tear also can result from either an acute injury or degenerative effects. It can be a partial tear, or a severing of the tendon. A complete tear entails a tendon being pulled apart from a bone. Injuries to the rotator cuff and biceps tendons are most often responsible for tears.
When the acromion exerts too much pressure on underlying soft tissues while the arm is lifted away from the body, impingement (or rubbing) can occur. That can cause bursitis, tendonitis and even rotator-cuff tears.
Shoulder instability involves the head of the upper arm bone being forced out of the shoulder socket, because of injury or overuse. Such dislocations can be partial or complete. Some patients suffer multiple recurrences, as shoulder ligaments, tendons and muscles become loose and more vulnerable to instability. The more times it happens, the greater the odds of arthritis developing.
The most common type of shoulder arthritis, osteoarthritis, is characterized by pain, inflammation and stiffness that generally starts in middle age. The condition gradually worsens, due to wear and tear of the joint over the years. Athletes, as well as workers who repeatedly reach above their heads, are particularly susceptible to osteoarthritis.
Other kinds of shoulder arthritis result from rotator-cuff tears, infections and inflammation of the joint lining.
An injury can break the clavicle, humerus or scapula. For seniors, falling is the typical cause of a shoulder fracture. Younger people are more likely to be injured in a traffic accident or while playing sports. Patients with broken shouder bones experience severe pain, swelling and bruising.
Orthopedists employ a variety of diagnostic tests to identify the cause of shoulder pain. They usually advise patients to rest the joint, and reduce or alter activities. However, inactivity may lead to stiffness, pain and lost range of motion. Doctors typically recommend physical therapy, and prescribe anti-inflammatory medication.
In about 10 percent of cases, surgery is required to relieve symptoms and restore shoulder function. Operations often are performed arthroscopically, a minimally invasive technique that involves only small incisions. For shoulder reconstruction or replacement, open surgery is conducted.
If you are experiencing shoulder pain, it is necessary to pinpoint its cause to determine the appropriate and effective treatment. Schedule an appointment for an evaluation by the nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego to learn about ways to relieve the discomfort and regain full use of your shoulder.

Knee pain can result from an injury, like a ruptured ligament or torn cartilage; or a medical condition, such as arthritis or gout. The discomfort may progress to the point that it becomes difficult to walk and engage in other simple, everyday activities.
The best type of treatment or knee surgery depends upon the cause of the pain and the degree to which function is limited.  The staff at Orthopedic Surgery San Diego conducts a range of diagnostic tests to determine the most effective ways to relieve the symptoms.
Many patients find relief by taking anti-inflammatory medication and receiving physical therapy. For others, surgical repair of the knee is necessary to regain full function.
Left untreated, conditions like osteoarthritis can cause pain that increases with age. Joint damage and disability also may result from failing to address the problem.
Symptoms of a knee ailment include swelling and stiffness, redness and a knee that is warm to the touch, weakness or instability, popping or crunching noises, and inability to fully straighten the knee. Experts advise seeking the services of a doctor when putting weight on the knee becomes too painful, inflammation increases, the joint is hard to flex, the knee or leg looks deformed, or the knee “gives out”.
Some patients, especially athletes and those who regularly engage in other activities that put excessive strain on their knees, are vulnerable to injuries. Damage may be inflicted on the joint’s ligaments, tendons, bones, cartilage, or bursa (liquid-filled sacs that cushion the bones and soft tissues).Skiers and people who play soccer or basketball are prone to tears and other injuries of the anterior cruciate ligament (ACL). It is one of four ligaments that connect the shin bone to the thigh bone. Meniscus, a type of cartilage between the shine bone and thigh bone, can tear when the knee is twisted.
Knee injuries sometimes inflame the bursa, which leads to bursitis. Another common condition, tendonitis, entails irritation and swelling of one or more of the tendons that hold bones and muscles together. Patellar tendonitis, which happens to athletes whose sports require running or jumping, affects a tendon that extends from the thigh to the shin bone.
An injury or long-term deterioration sometimes causes a bone or cartilage fragment to chip away and float within the knee. These fragments are called “loose bodies,” which are often harmless. In some cases, they adversely affect knee movements and cause pain. A dislocated kneecap features the patella, a bone in the front of the knee, being forced out of its proper location.
Osteoarthritis results from cartilage wearing away over the years. Rheumatoid arthritis produces varying degrees of pain that may come and go. Gout, another type of arthritis that can affect the knee, results from a buildup of uric acid.
Other afflictions include pseudogout, caused by calcium-laden crystals forming in the knee; septic arthritis, which results from infections; and patellofemoral pain syndrome, which produces pain between the patella and thigh bone. Some patients suffer discomfort in the knees due to one leg being longer than the other, or having improperly aligned knees or flat feet.
Overweight and obese people are most at risk of sustaining injuries or developing conditions that cause knee pain. The more weight that the joint bears, the faster the cartilage deteriorates. It is important to get sufficient exercise, to maintain knee strength and flexibility. When muscles tighten or weaken, they fail to properly support the knees when strain is placed on them.
To pinpoint the cause of a patient’s knee pain, a doctor performs a physical examination and conducts a range of medical tests, such as X-rays, CT scans, ultrasounds and MRIs.
While the optimal treatment depends upon the type and severity of the problem, patients usually first try to relieve their symptoms with drugs and exercise therapy. In some cases, doctors prescribe arch supports or knee braces. Another approach is to inject into the knee corticosteroids, or a thick fluid that lubricates the joint.
Surgical options include minimally invasive arthroscopic methods, in which tiny tools and a fiber-optic camera are inserted into the knee through small incisions. Open surgery is necessary for partial or total knee replacements using prosthetic devices.  In these surgical endeavors, knee arthritis is eliminated when metal implants are used to perform a total knee arthroplasty.  This  surgery is performed by an orthopedic surgeon.
If you are experiencing knee pain, it is necessary to identify the cause to determine the appropriate treatment or surgery. Schedule an appointment for an evaluation by the nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego to learn about ways to relieve the discomfort and regain full use of your knee.