The Peter Attia Drive

#264 ‒ Hip, knee, ankle, and foot: common injuries, prevention, and treatment options


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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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