Connect with us

The Conversation

Knee problems tend to flare up as you age – an orthopedic specialist explains available treatment options

Published

on

theconversation.com – Angie Brown, Clinical Associate Professor of Physical Therapy, Quinnipiac University – 2024-11-15 07:32:00

Knee problems can hinder mobility and erode your quality of life.

Witthaya Prasongsin/Moment via Getty Images

Angie Brown, Quinnipiac University

Knee injuries are common in athletes, accounting for 41% of all athletic injuries. But knee injuries aren’t limited to competitive athletes. In our everyday lives, an accident or a quick movement in the wrong direction can injure the knee and require medical treatment. A quarter of the adult population worldwide experiences knee pain each year

As a physical therapist and board-certified orthopedic specialist, I help patients of all ages with knee injuries and degenerative conditions.

Your knees have a huge impact on your mobility and overall quality of life, so it’s important to prevent knee problems whenever possible and address pain in these joints with appropriate treatments.

Healthy knees

The knee joint bones consist of the femur, tibia and patella. As in all healthy joints, smooth cartilage covers the surfaces of the bones, forming the joints and allowing for controlled movement.

diagram of a healthy knee

A healthy knee.

Inna Kharlamova/iStock/Getty Images Plus via Getty Images

Muscles, ligaments and tendons further support the knee joint. The anterior cruciate ligament, commonly known as the ACL, and posterior cruciate ligament, or PCL, provide internal stability to the knee. In addition, two tough pieces of fibrocartilage, called menisci, lie inside the joint, providing further stability and shock absorption.

All these structures work together to enable the knee to move smoothly and painlessly throughout everyday movement, whether bending to pick up the family cat or going for a run.

Causes of knee pain

Two major causes of knee pain are acute injury and osteoarthritis.

Ligaments such as the ACL and PCL can be stressed and torn when a shear force occurs between the femur and tibia. ACL injuries often occur when athletes land awkwardly on the knee or quickly pivot on a planted foot. Depending on the severity of the injury, these patients may undergo physical therapy, or they may require surgery for repair or replacement.

PCL injuries are less common. They occur when the tibia experiences a posterior or backward force. This type of injury is common in car accidents when the knee hits the dashboard, or when patients fall forward when walking up stairs.

The menisci can also experience degeneration and tearing from shear and rotary forces, especially during weight-bearing activities. These types of injuries often require rehabilitation through physical therapy or surgery.

Knee pain can also result from injury or overuse of the muscles and tendons surrounding the knee, including the quadriceps, hamstrings and patella tendon.

Both injuries to and overuse of the knee can lead to degenerative changes in the joint surfaces, known as osteoarthritis. Osteoarthritis is a progressive disease that can lead to pain, swelling and stiffness. This disease affects the knees of over 300 million people worldwide, most often those 50 years of age and up. American adults have a 40% chance of developing osteoarthritis that affects their daily lives, with the knee being the most commonly affected joint.

Age is also a factor in knee pain. The structure and function of your joints change as you age. Cartilage starts to break down, your body produces less synovial fluid to lubricate your joints, and muscle strength and flexibility decrease. This can lead to painful, restricted movement in the joint.

Risk factors

There are some risk factors for knee osteoarthritis that you cannot control, such as genetics, age, sex and your history of prior injuries.

Fortunately, there are several risk factors you can control that can predispose you to knee pain and osteoarthritis specifically. The first is excessive weight. Based on studies between 2017 and 2020, nearly 42% of all adult Americans are obese. This obesity is a significant risk factor for diabetes and osteoarthritis and can also play a role in other knee injuries.

A lack of physical activity is another risk, with 1 in 5 U.S. adults reporting that they’re inactive outside of work duties. This can result in less muscular support for the knee and more pressure on the joint itself.

An inflammatory diet also adds to the risk of knee pain from osteoarthritis. Research shows that the average American diet, often high in sugar and fat and low in fiber, can lead to changes to the gut microbiome that contribute to osteoarthritis pain and inflammation.

Preventing knee pain

Increasing physical activity is one of the key elements to preventing knee pain. Often physical therapy intervention for patients with knee osteoarthritis focuses on strengthening the knee to decrease pain and support the joint during movement.

The U.S. Department of Health and Human Services recommends that adults spend at least 150 to 300 minutes per week on moderate-intensity, or 75 to 150 minutes per week on vigorous-intensity aerobic physical activity. These guidelines do not change for adults who already have osteoarthritis, although their exercise may require less weight-bearing activities, such as swimming, biking or walking.

The agency also recommends that all adults do some form of resistance training at least two or more days a week. Adults with knee osteoarthritis particularly benefit from quadriceps-strengthening exercises, such as straight leg raises.

Treatments for knee pain

Conservative treatment of knee pain includes anti-inflammatory and pain medications and physical therapy.

Medical treatment for knee osteoarthritis may include cortisone injections to decrease inflammation or hyaluronic acid injections, which help lubricate the joint. The relief from these interventions is often temporary, as they do not stop the progression of the disease. But they can delay the need for surgery by one to three years on average, depending on the number of injections.

Physical therapy is generally a longer-lasting treatment option for knee pain. Physical therapy treatment leads to more sustained pain reduction and functional improvements when compared with cortisone injections treatment and some meniscal repairs.

YouTube video
Patients with osteoarthritis often benefit from total knee replacement, a surgery with a high success rate and lasting results.

Surgical interventions for knee pain include the repair, replacement or removal of the ACL, PCL, menisci or cartilage. When more conservative approaches fail, patients with osteoarthritis may benefit from a partial or total knee replacement to allow more pain-free movement. In these procedures, one or both sides of the knee joint are replaced by either plastic or metal components. Afterward, patients attend physical therapy to aid in the return of range of motion.

Although there are risks with any surgery, most patients who undergo knee replacement benefit from decreased pain and increased function, with 90% of all replacements lasting more than 15 years. But not all patients are candidates for such surgeries, as a successful outcome depends on the patient’s overall health and well-being.

New treatments on the horizon

New developments for knee osteoarthritis are focused on less invasive therapies. Recently, the U.S. Food and Drug Administration approved a new implant that acts as a shock absorber. This requires a much simpler procedure than a total knee replacement.

Other promising interventions include knee embolization, a procedure in which tiny particles are injected into the arteries near the knee to decrease blood flow to the area and reduce inflammation near the joint. Researchers are also looking into injectable solutions derived from human bodies, such as plasma-rich protein and fat cells, to decrease inflammation and pain from osteoarthritis. Human stem cells and their growth factors also show potential in treating knee osteoarthritis by potentially improving muscle atrophy and repairing cartilage.

Further research is needed on these novel interventions. However, any intervention that holds promise to stop or delay osteoarthritis is certainly encouraging for the millions of people afflicted with this disease.The Conversation

Angie Brown, Clinical Associate Professor of Physical Therapy, Quinnipiac University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More

The post Knee problems tend to flare up as you age – an orthopedic specialist explains available treatment options appeared first on theconversation.com

The Conversation

Contaminated milk from one plant in Illinois sickened thousands with Salmonella in 1985 − as outbreaks rise in the US, lessons from this one remain true

Published

on

theconversation.com – Michael Petros, Clinical Assistant Professor of Environmental and Occupational Health Sciences, University of Illinois Chicago – 2025-05-07 07:34:00

A valve that mixed raw milk with pasteurized milk at Hillfarm Dairy may have been the source of contamination. This was the milk processing area of the plant.
AP Photo/Mark Elias

Michael Petros, University of Illinois Chicago

In 1985, contaminated milk in Illinois led to a Salmonella outbreak that infected hundreds of thousands of people across the United States and caused at least 12 deaths. At the time, it was the largest single outbreak of foodborne illness in the U.S. and remains the worst outbreak of Salmonella food poisoning in American history.

Many questions circulated during the outbreak. How could this contamination occur in a modern dairy farm? Was it caused by a flaw in engineering or processing, or was this the result of deliberate sabotage? What roles, if any, did politics and failed leadership play?

From my 50 years of working in public health, I’ve found that reflecting on the past can help researchers and officials prepare for future challenges. Revisiting this investigation and its outcome provides lessons on how food safety inspections go hand in hand with consumer protection and public health, especially as hospitalizations and deaths from foodborne illnesses rise.

Contamination, investigation and intrigue

The Illinois Department of Public Health and the U.S. Centers for Disease Control and Prevention led the investigation into the outbreak. The public health laboratories of the city of Chicago and state of Illinois were also closely involved in testing milk samples.

Investigators and epidemiologists from local, state and federal public health agencies found that specific lots of milk with expiration dates up to April 17, 1985, were contaminated with Salmonella. The outbreak may have been caused by a valve at a processing plant that allowed pasteurized milk to mix with raw milk, which can carry several harmful microorganisms, including Salmonella.

Overall, labs and hospitals in Illinois and five other Midwest states – Indiana, Iowa, Michigan, Minnesota and Wisconsin – reported over 16,100 cases of suspected Salmonella poisoning to health officials.

To make dairy products, skimmed milk is usually separated from cream, then blended back together in different levels to achieve the desired fat content. While most dairies pasteurize their products after blending, Hillfarm Dairy in Melrose Park, Illinois, pasteurized the milk first before blending it into various products such as skim milk and 2% milk.

Subsequent examination of the production process suggested that Salmonella may have grown in the threads of a screw-on cap used to seal an end of a mixing pipe. Investigators also found this strain of Salmonella 10 months earlier in a much smaller outbreak in the Chicago area.

Microscopy image of six rod-shaped bacteria against a black background
Salmonella is a common cause of food poisoning.
Volker Brinkmann/Max Planck Institute for Infection Biology via PLoS One, CC BY-SA

Finding the source

The contaminated milk was produced at Hillfarm Dairy in Melrose Park, which was operated at the time by Jewel Companies Inc. During an April 3 inspection of the company’s plant, the Food and Drug Administration found 13 health and safety violations.

The legal fallout of the outbreak expanded when the Illinois attorney general filed suit against Jewel Companies Inc., alleging that employees at as many as 18 stores in the grocery chain violated water pollution laws when they dumped potentially contaminated milk into storm sewers. Later, a Cook County judge found Jewel Companies Inc. in violation of the court order to preserve milk products suspected of contamination and maintain a record of what happened to milk returned to the Hillfarm Dairy.

Political fallout also ensued. The Illinois governor at the time, James Thompson, fired the director of the Illinois Public Health Department when it was discovered that he was vacationing in Mexico at the onset of the outbreak and failed to return to Illinois. Notably, the health director at the time of the outbreak was not a health professional. Following this episode, the governor appointed public health professional and medical doctor Bernard Turnock as director of the Illinois Department of Public Health.

In 1987, after a nine-month trial, a jury determined that Jewel officials did not act recklessly when Salmonella-tainted milk caused one of the largest food poisoning outbreaks in U.S. history. No punitive damages were awarded to victims, and the Illinois Appellate Court later upheld the jury’s decision.

YouTube video
Raw milk is linked to many foodborne illnesses.

Lessons learned

History teaches more than facts, figures and incidents. It provides an opportunity to reflect on how to learn from past mistakes in order to adapt to future challenges. The largest Salmonella outbreak in the U.S. to date provides several lessons.

For one, disease surveillance is indispensable to preventing outbreaks, both then and now. People remain vulnerable to ubiquitous microorganisms such as Salmonella and E. coli, and early detection of an outbreak could stop it from spreading and getting worse.

Additionally, food production facilities can maintain a safe food supply with careful design and monitoring. Revisiting consumer protections can help regulators keep pace with new threats from new or unfamiliar pathogens.

Finally, there is no substitute for professional public health leadership with the competence and expertise to respond effectively to an emergency.The Conversation

Michael Petros, Clinical Assistant Professor of Environmental and Occupational Health Sciences, University of Illinois Chicago

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More

The post Contaminated milk from one plant in Illinois sickened thousands with Salmonella in 1985 − as outbreaks rise in the US, lessons from this one remain true appeared first on theconversation.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Centrist

The article provides an analytical, factual recounting of the 1985 Salmonella outbreak, with an emphasis on public health, safety standards, and lessons learned from past mistakes. It critiques the failures in leadership and oversight during the incident but avoids overt ideological framing. While it highlights political accountability, particularly the firing of a public health official and the appointment of a medical professional, it does so in a balanced manner without assigning blame to a specific political ideology. The content stays focused on the public health aspect and the importance of professional leadership, reflecting a centrist perspective in its delivery.

Continue Reading

The Conversation

Predictive policing AI is on the rise − making it accountable to the public could curb its harmful effects

Published

on

theconversation.com – Maria Lungu, Postdoctoral Researcher of Law and Public Administration, University of Virginia – 2025-05-06 07:35:00

Data like this seven-day crime map from Oakland, Calif., feeds predictive policing AIs.
City of Oakland via CrimeMapping.com

Maria Lungu, University of Virginia

The 2002 sci-fi thriller “Minority Report” depicted a dystopian future where a specialized police unit was tasked with arresting people for crimes they had not yet committed. Directed by Steven Spielberg and based on a short story by Philip K. Dick, the drama revolved around “PreCrime” − a system informed by a trio of psychics, or “precogs,” who anticipated future homicides, allowing police officers to intervene and prevent would-be assailants from claiming their targets’ lives.

The film probes at hefty ethical questions: How can someone be guilty of a crime they haven’t yet committed? And what happens when the system gets it wrong?

While there is no such thing as an all-seeing “precog,” key components of the future that “Minority Report” envisioned have become reality even faster than its creators imagined. For more than a decade, police departments across the globe have been using data-driven systems geared toward predicting when and where crimes might occur and who might commit them.

Far from an abstract or futuristic conceit, predictive policing is a reality. And market analysts are predicting a boom for the technology.

Given the challenges in using predictive machine learning effectively and fairly, predictive policing raises significant ethical concerns. Absent technological fixes on the horizon, there is an approach to addressing these concerns: Treat government use of the technology as a matter of democratic accountability.

Troubling history

Predictive policing relies on artificial intelligence and data analytics to anticipate potential criminal activity before it happens. It can involve analyzing large datasets drawn from crime reports, arrest records and social or geographic information to identify patterns and forecast where crimes might occur or who may be involved.

Law enforcement agencies have used data analytics to track broad trends for many decades. Today’s powerful AI technologies, however, take in vast amounts of surveillance and crime report data to provide much finer-grained analysis.

Police departments use these techniques to help determine where they should concentrate their resources. Place-based prediction focuses on identifying high-risk locations, also known as hot spots, where crimes are statistically more likely to happen. Person-based prediction, by contrast, attempts to flag individuals who are considered at high risk of committing or becoming victims of crime.

These types of systems have been the subject of significant public concern. Under a so-called “intelligence-led policing” program in Pasco County, Florida, the sheriff’s department compiled a list of people considered likely to commit crimes and then repeatedly sent deputies to their homes. More than 1,000 Pasco residents, including minors, were subject to random visits from police officers and were cited for things such as missing mailbox numbers and overgrown grass.

YouTube video
Lawsuits forced the Pasco County, Fla., Sheriff’s Office to end its troubled predictive policing program.

Four residents sued the county in 2021, and last year they reached a settlement in which the sheriff’s office admitted that it had violated residents’ constitutional rights to privacy and equal treatment under the law. The program has since been discontinued.

This is not just a Florida problem. In 2020, Chicago decommissioned its “Strategic Subject List,” a system where police used analytics to predict which prior offenders were likely to commit new crimes or become victims of future shootings. In 2021, the Los Angeles Police Department discontinued its use of PredPol, a software program designed to forecast crime hot spots but was criticized for low accuracy rates and reinforcing racial and socioeconomic biases.

Necessary innovations or dangerous overreach?

The failure of these high-profile programs highlights a critical tension: Even though law enforcement agencies often advocate for AI-driven tools for public safety, civil rights groups and scholars have raised concerns over privacy violations, accountability issues and the lack of transparency. And despite these high-profile retreats from predictive policing, many smaller police departments are using the technology.

Most American police departments lack clear policies on algorithmic decision-making and provide little to no disclosure about how the predictive models they use are developed, trained or monitored for accuracy or bias. A Brookings Institution analysis found that in many cities, local governments had no public documentation on how predictive policing software functioned, what data was used, or how outcomes were evaluated.

YouTube video
Predictive policing can perpetuate racial bias.

This opacity is what’s known in the industry as a “black box.” It prevents independent oversight and raises serious questions about the structures surrounding AI-driven decision-making. If a citizen is flagged as high-risk by an algorithm, what recourse do they have? Who oversees the fairness of these systems? What independent oversight mechanisms are available?

These questions are driving contentious debates in communities about whether predictive policing as a method should be reformed, more tightly regulated or abandoned altogether. Some people view these tools as necessary innovations, while others see them as dangerous overreach.

A better way in San Jose

But there is evidence that data-driven tools grounded in democratic values of due process, transparency and accountability may offer a stronger alternative to today’s predictive policing systems. What if the public could understand how these algorithms function, what data they rely on, and what safeguards exist to prevent discriminatory outcomes and misuse of the technology?

The city of San Jose, California, has embarked on a process that is intended to increase transparency and accountability around its use of AI systems. San Jose maintains a set of AI principles requiring that any AI tools used by city government be effective, transparent to the public and equitable in their effects on people’s lives. City departments also are required to assess the risks of AI systems before integrating them into their operations.

If taken correctly, these measures can effectively open the black box, dramatically reducing the degree to which AI companies can hide their code or their data behind things such as protections for trade secrets. Enabling public scrutiny of training data can reveal problems such as racial or economic bias, which can be mitigated but are extremely difficult if not impossible to eradicate.

Research has shown that when citizens feel that government institutions act fairly and transparently, they are more likely to engage in civic life and support public policies. Law enforcement agencies are likely to have stronger outcomes if they treat technology as a tool – rather than a substitute – for justice.The Conversation

Maria Lungu, Postdoctoral Researcher of Law and Public Administration, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More

The post Predictive policing AI is on the rise − making it accountable to the public could curb its harmful effects appeared first on theconversation.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

The article provides an analysis of predictive policing, highlighting both the technological potential and ethical concerns surrounding its use. While it presents factual information, it leans towards caution and skepticism regarding the fairness, transparency, and potential racial biases of these systems. The framing of these issues, along with an emphasis on democratic accountability, transparency, and civil rights, aligns more closely with center-left perspectives that emphasize government oversight, civil liberties, and fairness. The critique of predictive policing technologies without overtly advocating for their abandonment reflects a balanced but cautious stance on technology’s role in law enforcement.

Continue Reading

The Conversation

Worsening allergies aren’t your imagination − windy days create the perfect pollen storm

Published

on

theconversation.com – Christine Cairns Fortuin, Assistant Professor of Forestry, Mississippi State University – 2025-05-05 07:45:00

Windy days can mean more pollen and more sneezing.
mladenbalinovac/E+ via Getty Images

Christine Cairns Fortuin, Mississippi State University

Evolution has fostered many reproductive strategies across the spectrum of life. From dandelions to giraffes, nature finds a way.

One of those ways creates quite a bit of suffering for humans: pollen, the infamous male gametophyte of the plant kingdom.

In the Southeastern U.S., where I live, you know it’s spring when your car has turned yellow and pollen blankets your patio furniture and anything else left outside. Suddenly there are long lines at every car wash in town.

A car covered in yellow. Someone drew a smiley face with the words 'LOLLEN,' with LOL underlined.
On heavy pollen days, cars can end up covered in yellow grains.
Scott Akerman/Flickr, CC BY

Even people who aren’t allergic to pollen – clearly an advantage for a pollination ecologist like me – can experience sneezing and watery eyes during the release of tree pollen each spring. Enough particulate matter in the air will irritate just about anyone, even if your immune system does not launch an all-out attack.

So, why is there so much pollen? And why does it seem to be getting worse?

2 ways trees spread their pollen

Trees don’t have an easy time in the reproductive game. As a tree, you have two options to disperse your pollen.

Option 1: Employ an agent, such as a butterfly or bee, that can carry your pollen to another plant of the same species.

The downside of this option is that you must invest in a showy flower display and a sweet scent to advertise yourself, and sugary nectar to pay your agent for its services.

A bee noses into a white flower.
A bee enjoys pollen from a cherry blossom. Pollen is a primary source of protein for bees.
Ivan Radic/Flickr, CC BY

Option 2, the budget option, is much less precise: Get a free ride on the wind.

Wind was the original pollinator, evolving long before animal-mediated pollination. Wind doesn’t require a showy flower nor a nectar reward. What it does require for pollination to succeed is ample amounts of lightweight, small-diameter pollen.

Why wind-blown pollen makes allergies worse

Wind is not an efficient pollinator, however. The probability of one pollen grain landing in the right location – the stigma or ovule of another plant of the same species – is infinitesimally small.

Therefore, wind-pollinated trees must compensate for this inefficiency by producing copious amounts of pollen, and it must be light enough to be carried.

For allergy sufferers, that can mean air filled with microscopic pollen grains that can get into your eyes, throat and lungs, sneak in through window screens and convince your immune system that you’ve inhaled a dangerous intruder.

Tiny flowers on a live oak tree.
When wind blows the tiny pollen grains of live oaks, allergy sufferers feel it.
Charles Willgren/Flickr, CC BY

Plants relying on animal-mediated pollination, by contrast, can produce heavier and stickier pollen to adhere to the body of an insect. So don’t blame the bees for your allergies – it’s really the wind.

Climate change has a role here, too

Plants initiate pollen release based on a few factors, including temperature and light cues. Many of our temperate tree species respond to cues that signal the beginning of spring, including warmer temperatures.

Studies have found that pollen seasons have intensified in the past three decades as the climate has warmed. One study that examined 60 location across North America found pollen seasons expanded by an average of 20 days from 1990 to 2018 and pollen concentrations increased by 21%.

That’s not all. Increasing carbon dioxide levels may also be driving increases in the quantity of tree pollen produced.

Why the Southeast gets socked

What could make this pollen boost even worse?

For the Southeastern U.S. in particular, strong windstorms are becoming more common and more intense − and not just hurricanes.

Anyone who has lived in the Southeast for the past couple of decades has likely noticed this. The region has more tornado warnings, more severe thunderstorms, more power outages. This is especially true in the mid-South, from Mississippi to Alabama.

A map showing windiest events in the Southeast are over Alabama and Mississippi.
Severity of wind and storm events mapped from NOAA data, 2012-2019, shows high activity over Mississippi and Alabama. Red areas have the most severe events.
Christine Cairns Fortuin

Since wind is the vector of airborne pollen, windier conditions can also make allergies worse. Pollen remains airborne for longer on windy days, and it travels farther.

To make matters worse, increasing storm activity may be doing more than just transporting pollen. Storms can also break apart pollen grains, creating smaller particles that can penetrate deeper into the lungs.

Many allergy sufferers may notice worsening allergies during storms.

The peak of spring wind and storm season tends to correspond to the timing of the release of tree pollen that blankets our world in yellow. The effects of climate change, including longer pollen seasons and more pollen released, and corresponding shifts in windy days and storm severity are helping to create the perfect pollen storm.The Conversation

Christine Cairns Fortuin, Assistant Professor of Forestry, Mississippi State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Read More

The post Worsening allergies aren’t your imagination − windy days create the perfect pollen storm appeared first on theconversation.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Centrist

The content is a scientific and educational article focusing on the biology of pollen, its effects on allergies, and the influence of climate change on pollen production. It presents factual information supported by research studies and references, without taking a partisan stance. While it acknowledges climate change as a factor, the discussion remains grounded in scientific observation rather than political opinion, leading to a neutral, centrist tone.

Continue Reading

Trending