本期播客由骨科医生Adam Cohen主讲，详细解析了下肢（髋、膝、踝、足）的解剖结构、常见损伤、疼痛来源及关节炎的发展。Cohen医生深入探讨了非手术和手术治疗方案，以及决定是否需要手术的因素。内容涵盖髋关节置换、膝关节置换、ACL重建、半月板撕裂修复等多种手术，并介绍了干细胞和富血小板血浆（PRP）等生物疗法的应用。此外，节目还讨论了运动对关节的影响、运动员康复经验及如何选择优秀的骨科医生。

🦴 **髋关节解剖与问题：** 节目首先介绍了髋关节的解剖结构，包括婴儿髋关节发育不良及关节炎的形成。探讨了50岁以下人群的髋关节疼痛诊断，以及股骨颈应力性骨折等问题。

🦵 **膝关节损伤与治疗：** 详细讲解了膝关节的解剖结构，讨论了跑步等高强度运动对膝关节的影响。重点介绍了ACL损伤的发生机制及修复方法，以及膝关节炎的治疗。此外，还分析了半月板撕裂的发生原因及手术指征，并对比了全膝关节置换与髋关节置换的恢复过程。

🦶 **踝、足部损伤与康复：** 节目涵盖了踝关节和足部的解剖结构，以及常见的损伤。讨论了跟腱炎、跟腱断裂的预防策略。节目还分享了从精英运动员身上学习到的经验，如心率恢复、最大摄氧量等指标，并提供了如何选择优秀骨科医生的建议。

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Adam Cohen is an orthopedic surgeon with expertise in sports medicine. In this episode, Adam breaks down the anatomy of the lower extremities: the hip, knee, ankle, and foot. He explains in detail the common injuries, sources of pain, and what leads to the development of arthritis. He lays out the non-surgical and surgical treatment options as well as the factors that determine whether surgery is appropriate. The discussion includes various procedures like hip replacement, knee replacement, ACL reconstruction, repair of meniscus tears, and more. Additionally, Adam sheds light on the utility of biological therapies like stem cells and platelet-rich plasma (PRP) and how they compare to more traditional approaches.

We discuss:

Anatomy of the hip, hip dysplasia in infants, and the development of arthritis [3:00]; Diagnosing hip pain in people under 50, stress fractures in the femoral neck, and more [11:15]; Common hip injuries, gender differences, and problems that occur when the hip isn’t formed normally [19:30]; Advancements in hip replacement surgery [25:15]; Common hip problems in people over age 60 [27:30]; The importance of muscular strength around the hips for injury prevention [30:30]; Hip fractures due to osteopenia and osteoporosis [36:00]; The utility of biological therapies like stem cells and platelet-rich plasma (PRP) [40:30]; Cortisone as a treatment to delay the need for surgical intervention [53:30]; Anatomy of the knee [56:30]; Are activities like running that amplify forces bad for the knee? [59:45]; Risk of future knee issues and arthritis following an ACL tear or other substantial knee injury [1:04:30]; How the ACL injury happens and how it is repaired [1:08:30]; Arthritis of the knee [1:19:00]; Meniscus tears: how they happen and when surgery is appropriate [1:21:30]; Total knee replacement: when it’s appropriate and how the recovery process compares to hip replacement [1:30:30]; Learning from elite athletes, heart rate recovery, V02 max, and other metrics [1:58:45]; Surgical vs. non-surgical approaches to various knee injuries [1:40:45]; Achilles tendon: tendinitis, rupture of the Achilles tendon, and prevention strategies [1:44:15]; Anatomy of the ankle and foot [1:49:00]; Common injuries to the ankle and foot [1:51:15]; Tips for finding a good orthopedic surgeon [2:01:45]; and More.

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