More than 500 000 persons in the United States have knee replacements each year. The most common reason for knee replacement is osteoarthritis. Osteoarthritis is destruction of the cartilage (supporting tissue between layers of a joint) and can occur at any joint in the body, but the knees are often the first site. Osteoarthritis causes pain, stiffness, limitation of motion, and swelling in the area of the joint that has arthritis. Rheumatoid arthritis, destruction of joint cartilage by an immune process, affects joints differently. Persons with rheumatoid arthritis often have deformities in the joints, along with pain, swelling, stiffness, and problems in other areas of their bodies. Referral to an orthopedic surgeon and evaluation for knee replacement may be offered when other treatments for osteoarthritis or rheumatoid arthritis fail. Orthopedic surgeons are doctors with specialized education in the diagnosis and treatment of bone and joint disorders.

It's a well-known fact that medical care in the United States is first-rate. It's also well accepted that for patients struggling with a serious, rare, or complicated condition, one of our teaching hospitals is probably the best place to be. People with difficult medical problems regularly seek out, at least if they have the ability, the institutions at the forefront of research and education. Such settings typically have the most high-tech equipment, the most sophisticated labs, and the most experienced clinicians.

To most people, 80049, 80051, 80054, and 80058 are just big, boring numbers. But beginning Aprill, these figures became a major concern to every practicing physician in the United States. They are Current Procedural Terminology (CPT) codes that represent to physicians, laboratory staff, and healthcare billing departments the latest in governmental regulation and a monumental intrusion into medical practice.

When I first got the invitation to join a medical delegation going to Moldova, I thought for a moment that our destination was the fictional country in the old Marx Brothers movie Duck Soup. On further checking, it turns out that entertaining place was called Freedonia. I now know that Moldova is indeed a real country, bordered on the west by Romania and on the other three sides by the Ukraine. It is a proud country, rich with traditions, and its people are warm, giving, eager to learn ways to improve their healthcare system, and deeply appreciative of our attempts to help them in the task.

(1997). Smoking and chewing in young people. Postgraduate Medicine: Vol. 101, No. 3, pp. 13-18.