ronald dulan-waha. he is here to talk about joint problems and how to detect them. good morning to you. >> good morning. >> let's first talk about how do people know if it is joint pain or something more serious or less serious? >> it is interesting. joint pain is not very complex. it is their joint hurts. their knee hurts, their elbow hurts, their hip hurts. the hip is a little more tricky. sometimes people point to the low back. they think it is their hip, but it is not. it is generally in their groin. >> you said there have -- has been an increase in joint replacements? >> yes. there is an increase in joint replacements and joint pain. no one really knows why, but we believe some of the contributing factors is people's weight. we're a country with obesity. and potentially in conjunction with increased activity. so you are seeing the combination. the deadly -- and decreased activity. the deadly two. >> if someone has chronic joint pain is it necessary to get a joint replacement or do you find if someone has severe pain they are going to need some sort of replacement? >> no, no, no. i think the majority of my patients that come to see me do not need surgery. at the rubin institute we try not to replace joints. we do everything we can to preserve people's joints in a variety of techniques. >> talk about some of the symptoms of joint and some of the nonsurgical methods you use? > sure. the most common problem or presentation of joint pain is pain in itself or loss of function. the patient will also have to come in and say i can't do what i wanted to do. i can't play the game i wanted to play. that limiting factor, that desire to stay active is lost. in terms of what we utilize, we utilize a variety of things. first and foremost, education. second is potentially injections, physical therapy. we actually have braces that are unique that we utilize in the rubin institute. we do investigational studies. some braces that hopefully alter the joint mechanics and improve the lpt or life span of the joint. then, as i said, injecks. the last resort is surgery. >> speaking of education, you brought the modelts here. i don't know if you want today explain to folks up there. are these the -- are these some of the techniques? >> these are actually joint replacements. what i wanted to show is some of the newer things going on in joint replacement. there was a big surge for metal and metal, which is a type of bearing surface. we talk about hip replacement. specifically we talked about how the two combine each other, how they wear. the conventional technique is how they -- i can show you here, is plastic. >> ok. >> which is plastic. the head moves around into the plastic. >> this all in here, this goes in your body, right? >> this goes into the pelvis, and this goes into the shaft of the femur. they move in this information. it works very, very well. the new plastics are actually phenomenal. there have been changes you may have heard of, in terms of metal and metal. some of the newest products out currently are what's called a mobalt hip. as you can see the difference, it is a larger -- it has a larger inner parameter. there are two points of motion inside and outside. >> i appreciate you showing us. hopefully i won't need any joint replacement. but if i do, i'll come to you. thank you, doctor, for joining us. >> don't go away. when we come back, we'll look at a story out of kentucky where mothers are taking their breast milk and putting it in the state's first-ever breast milk depot. >> first, let's look at some of