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Broken Knee Cartilage is Forever

A team of researchers at the University of Western Ontario in London, Ontario showed that arthroscopic trimming of knee cartilage is no better than doing no surgery at all (NEJM, September 11, 2008). Another study that also used sham surgery was done at Baylor Medical School and showed the same results (New England Journal of Medicine 2002;347:81-8). The procedure is done when a surgeon inserts small tubes through the skin into the knee joint and trims the edges of cartilage and removes loose pieces of cartilage from the joint.

You hear about many athletes returning to the athletic field after breaking cartilage in their knees and having surgery. However, almost all will have pain in their knees for the rest of their lives and most will eventually have their knees replaced. When you break cartilage in your knee, it will never heal.

If you hurt your knee and the pain persists, your doctor will probably order an MRI. If it shows that you have a crack in your cartilage, you should never run or jump again. When you run, the force of your foot striking the ground is transmitted up to your knee and can extend the existing cracks. Running 6-minute miles exerts a force exceeding three times body weight. Landing from a jump exerts even greater force on your knee joint. You can usually ride a bike safely because you pedal in a smooth rotary motion that exerts little force on your knee joint. Swimming is also usually safe for your knees.

If you extend the cracks in your knee cartilage, you can have pain all the time. Then it is probably time for you to have knee replacement surgery. Surgery is also indicated for a torn anterior cruciate ligament. Your knee is really two sticks held together by four bands called ligaments. You can tear any one of three of these bands and usually do quite well. However if you tear the anterior cruciate ligament, the cartilage of your lower leg is allowed to slip backwards against that of your upper leg and shear off additional cartilage, eventually necessitating a knee replacement. So almost always doctors recommend replacing a torn anterior cruciate ligament.

Contact sports that require running and jumping, such as football and soccer, are the ones that put you at increased risk for knee damage. Once you crack cartilage in your knees, you probably should avoid all sports that require running and jumping. Most people can ride or even race on bicycles and not extend their knee damage.

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Dear Dr. Mirkin: Why do my muscles get smaller as I get older?

A study from Boston University School of Medicine shows that with aging, a man's testosterone blood levels drop, causing muscle to shrink and fat cells to fill (Journal of the American Geriatrics Society, September 2008). So if you are a man who doesn't like to become fatter and weaker, you better start an exercise program and keep it up for the rest of your life. Other studies show that lowered testosterone levels are also associated with increased risk for diabetes, heart attacks and Strokes.

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Dear Dr. Mirkin: Do you still think that cell phones are unsafe?

In previous reports I have written that the safety of cell phones is highly controversial, but it takes tremendous power to send messages from your phone to a tower many miles away and the microwaves that do this can damage cells. Worms exposed to the same dosages of microwaves from phones cause worms to release heat shock protein, a sign of tissue damage, so I recommend that you do not let the antenna of a cell phone come within two inches of your head. I use an earpiece to accomplish this.

A study in the online version of Fertility and Sterility (September 19, 2008) shows that men who keep cell phones in their pockets or on their belts have lower sperm counts. By itself, this study is not a cause for concern, but it still offers a message to be cautious.

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Recipe of the Week

Portobello Mushroom Casserole

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June 22nd, 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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