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Knee Replacement Surgery

When all the cartilage in your knee is gone, the only effective treatment is to replace the whole knee. Knee replacements are now lasting for twelve to twenty years or more, and most remain pain-free.

The ends of bones are soft, so they must be covered with a thick white gristle called cartilage. Once damaged, cartilage can never heal. An affected person spends the rest of his life losing cartilage until the cartilage is completely gone and the knee hurts 24 hours a day. The only effective treatment at that time is to replace the entire knee. However, the artificial knee can become dislodged from the bones and may need to be replaced after several years. The area will be so full of scar tissue that a second surgery is far more difficult than the first.

If you have damaged cartilage in your knee, you should protect that knee for the rest of your life. Running, fast walking and jumping cause further damage, while pedaling and swimming usually do not. When the knee hurts all the time, your doctor will check to see how much cartilage is left. If it's gone, you probably need a knee replacement.

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Dear Dr. Mirkin: Do the products that claim to get rid of fat while you sleep really work?

Please don’t be taken in by ads that say you will burn fat instead of sugar while you sleep. Even if the products worked, you burn so few calories during sleep that it is irrelevant whether you are burning sugar or fat.

Your body burns primarily fat and sugar for energy. The harder you exercise, the more sugar your muscles use. You use the lowest percentage of fat when you exercise and the highest percentage when you sleep. Your body converts fat into sugar and sugar into fat, so the crucial factor is how many calories you burn, and not whether you burn more fat or sugar. For example, the average 150 pound person burns about 60 calories an hour during sleep, compared to more than 600 calories per hour while jogging. If you burn 80 percent fat during sleep, you will burn 48 calories of fat or one fifth of an ounce. If you burn 50 percent fat when you exercise, you will burn 1.3 ounces of fat per hour or more than six times as much.

There are many other products on the market today that promise to help you lose weight. None will help you unless they get you to exercise more and eat fewer calories. If you are serious about losing weight, learn to eat lots of vegetables, fruits, whole grains and beans; avoid concentrated sources of fats, especially saturated fats and partially hydrogenated oils; and stay away from refined carbohydrates (foods made with flour, white rice or milled corn, and all added sugars). Start an exercise program that alternates upper and lower body sports, such as pulling on a rowing machine and dancing.

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Dear Dr. Mirkin: When you stop exercising, do your muscles will turn into fat? A friend of mine tells me that’s why she won’t work out.

That’s a lousy reason for being out of shape. Muscles can't possibly turn to fat. When you exercise, your muscles become larger and stronger because exercise causes extra protein building blocks, called amino acids, to deposit in muscles. All day long, amino acids pass from your muscles into your bloodstream and then back into muscles. Exercise is the major stimulus to force amino acids back into muscles.

When you stop exercising, fewer amino acids go into your muscles so the muscles get smaller. Your body has no way to store extra protein, so amino acids that are not used in your muscles are picked up by your liver, which uses them for energy or converts them into fat for storage. So if you stop exercising, you have to eat less or you will gain weight. But muscles never turn into fat.

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Recipe of the Week:
Gingered Fruit Compote

List of Diana's Healthful Recipes

June 26th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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