Nitrogen gas exchange in the human knee

Human decompression sickness is presumed to result from excess inert gas in the body when ambient pressure is reduced. Although the most common symptom is pain in the skeletal joints, no direct study of nitrogen exchange in this region has been undertaken. For this study, nitrogen tagged with radioactive 13N was prepared in a linear accelerator. Nine human subjects rebreathed this gas from a closed circuit for 30 min, then completed a 40- to 100-min washout period breathing room air. The isotope 13N was monitored continuously in the subject's knee during the entire period using positron detectors. After correction for isotope decay (half-life = 9.96 min), the concentration in most knees continued to rise for at least 30 min into the washout period. Various causes of this unexpected result are discussed, the most likely of which is an extensive redistribution of gas within avascular knee tissues.