Case Studies

A patient with no history of knee problem in the past presents to the center with the complaint of knee pain for the past two weeks. He describes the pain to be mostly at level of medial site (medical lingo: inner part), knee feels weak and wants to give away. Past medical history is unremarkable, He does not smoke, but he drinks alcohol socially. Anti-inflammatory and 3 sessions of physical therapy have helped somewhat. On Physical exam there is minimal edema (medical lingo: swelling) and there is point tenderness on palpation and a tender movable mass (about 1/4 inch in diameter) at the level of femoral condoyle).

College Football player came in last week with chief complaint of weakness in the left knee. Patient had an injury during a game about 2 years ago which was followed by arthroscopy, in which part of his cartilage was removed. He has no pain unless he plays hard in his football matches. His past medical history is unremarkable and he is very healthy. He is concerned since he is a good candidate to be signed up next year in NFL (National Football League).

81 year old female with no history of knee problem or pain in the past came in today complaining of sudden onset of knee swelling which started as of last night. Patient states as she was sitting she suddenly felt her knee swelled up, this was followed by severe pain. Her past medical history is significant for Atrial Fibrillation for which she takes coumadin (Warfarin). On her exam knee was edematous (medical lingo: swelled up) and tender to touch. Patient was unable to flex the knee. A needle was placed in the knee and about 100 cc of blood was drained. The blood that was drained never clotted.

A 36 year old male came in today for evaluation of his left knee. Patient is concerned about preventive care and avoiding future arthritis, surgeries and possible total knee replacement He states about 3 years ago while skiing he had a fall. At that time it was very painful and he needed emergency personnel to bring him down the slopes using stretcher. He had an MRI initially that showed partial tear of his ACL (Anterior Cruciate Ligament). Patient had some physical therapy and he was able to get some self healing subsequently.

A professional Basketball player came in for evaluation and treatment; complaining of knee pain mostly below the level of knee cap. Patient has been experiencing the pain now for sometimes mostly during playing the game specifically while jumping. He is otherwise very healthy and strong, does not smoke or drink alcohol. He takes Glucosamine daily.

50 year-old woman who has experienced knee pain in her left knee for several years states that the knee becomes swollen at various times without apparent reason. She describes the location of the pain as deep in joint, explaining the discomfort felt is not exacerbated by personal or environmentally-oriented factors, such as diet, exercise, weather conditions, etc. Neither a smoker nor user of alcoholic beverages, she says the pain responds well to anti-inflammatory medications.

Professional basketball player, came in for evaluation and treatment. Patient states that two years ago while playing in a game he injured himself by twisting his right knee, since then his performance is not quite the same. He really has no pain when he walks; discomfort is only during playing especially the jumping affects his game. His past medical history is unremarkable; he is very healthy and athletic. Hardly takes any anti-inflammatory, never smokes and does not drink. Patient still has several more years on his contract, and he is concerned about preventing arthritis in future.

PL is a 49 year old male who initially damaged his right knee playing Football in his youth. Patient initially was seen in our office on February of 2003. At that point he was told he needs a total knee replacement, but due to his age doctors advised him against it. His past medical history is otherwise unremarkable. Patient does not smoke and only drinks socially. On exam he had point tenderness to the medial side (medical lingo: inner side). An X-Ray showed severe arthritis of the knee (X-ray on the left). Patient started receiving treatments at the Center for regenerative Medicine.

A 71 year old obese female with history of knee pain presents to the office for evaluation and treatment. Patient states she has no pain as long as she is sitting, going downstairs hurts her much more than going up. Knees are always swelled up. Knees get real stiff after sitting for about 30 minutes. She has to use a pillow between her knees when she sleeps. She can not walk more than a few steps before stopping. Her past medical history is negative for Rheumatoid or any other connective tissue diseases. Tylenol helps some times.

A 58 year old female from Venezuela presenting with advanced osteoarthritis of right knee. Patient complaints of pain mostly upon walking. Pain at times wakes the patient up. Pain is also localized to Posterior lateral aspect (Outer back) of the right knee. Her past medical history is positive for obesity, and hysterectomy. She gets some relief with Motrin as well as Glucosamine.

“The wear pattern on your running shoes suggests that you watch too much TV.”
A 50- year-old
male who has experienced intermittent pain in the right knee for the past three years presents with chief complaint of constant and severe pain “Off and on for the past two months,” An interference with his accustomed lifestyle, the pain is described as “continuous but worse when walking or putting weight on the knee.” The pain lessens but remains uncomfortable upon sitting, he adds.

Cartoon courtesy of Hallmark A 67-year-old female, physically active as a competitive tennis player, came to the Clinic for consultation, complaining of right knee pain. She states she does not like the "grating sound" heard upon flexing her knee. A review of her medical history discloses she is a non-smoker and an occasional consumer of alcoholic beverages. She is otherwise in good health. She takes anti-inflammatory medications for her pain.

A 65 year old male with chief complaint of knee pain, presenting with bone on bone osteoarthritis of left knee was referred to us by his physician for prevention of total knee replacement. Patient past history is positive for a Basketball injury in 1980, which was followed by a knee surgery. He is otherwise healthy, does not smoke and drinks only on social bases. There is no family history of osteoarthritis. His symptoms are specific to pain, stairs specially bother him. He experiences stiffness after sitting more than 10 minutes. On the exam the knee is extremely bowlegged.

Left: X-ray of the patient's right knee shows the transplanted tissue attached to the Tibia by means of 3 screws. A 59-year-old Massachusetts female was presented with concern for right knee rejection of a bone/cartilage transplant, recurring dislocation, and instability of the knee for several years. Patient had been plagued with a knee problem since a skiing accident 10 years ago. A year after initial injury, a metal plate was attached to strengthen the knee joint, followed by an Osteochondral Allograft surgical procedure which transplants a cartilage section and attached bone from a cadaver donor to the damaged region of the joint surface.

A 77-year-old male from New Jersey presented the Clinic with a complaint chiefly of right knee pain, stating pain occurs almost continually. Pain described as dull, worse when walking, and mostly located medially (inner knee area ). Pain has persisted for 30 years since an incident while patient walked downstairs at home when knee 'locked' at 90-degree angle. Prior to locking episode, patient was an avid sportsman and runner, never experiencing pain in either pursuit. At time that knee lock occurred, a physician

An 80 year old WWII Veteran presents with chief complaint of knee pain, patient states he has had pain in the left knee since World War II. He describes while fighting in Germany, he was shot in the knee by the enemy forces.

Subsequently he developed infection and necrosis  which required surgery and removal of bone and soft tissue, this was followed by 5 months of hospitalization and IV antibiotics, If it wasn't for Penicillin, they would have had to amputate my knee.

A 43-year old male presents a chief complaint of knee pain, stating pain in left knee only occurs when walking or knee is overextended. Pain is occasionally nagging, located primarily in upper mid-knee area. Pain has existed only for the past six months, having started immediately after a sudden twist of knee as patient descended a ladder. Patient relates he never experienced knee pain (or even twinge) in knee since skiing accident nearly 20 years previously when he recalls a nice jump gone bad-- apparent outward push of left foot in wrong direction, forcing left knee to twist.

Knee pain is the most common condition seen at The Center for Regenerative Medicine, with 90% of the patient load being some type of knee pain, top ten etiologies of Knee pain treated are:#1 Osteoarthritis Osteoarthritis is by far the most common cause of knee pain seen at The Center for regenerative Medicine.

At the 10th World Congress on Osteoarthritis in Boston Steven A. Mazzuca, Ph.D. said earlier: Lower-extremity strength training may help to slow down the progression of knee osteoarthritis symptoms in older individuals than do conventional range-of-motion exercises. Several previous studies have linked quadriceps weakness with osteoarthritis, suggesting that weak leg muscles may be a risk factor for the incidence of the condition, said Dr. Mazzuca of the division of rheumatology at Indiana University in Indianapolis.