Minimally Invasive Partial Knee Replacement Rules

I just returned from our annual American Academy of Orthopaedic Surgeons meeting and heard outstanding news!! Researchers have agreed that a partial knee replacement (arthroplasty) is more successful than a total knee replacement. The pain relief is similar but the complications and recovery are much less!!
I have been one of the first surgeons to perform partial knee replacements in Los Angeles and I have reported similar results in many publications over the years.
I strongly believe that a partial is best!!
Please call us at the Los Angeles Orthopaedic Institute and learn if this minimally invasive procedure is right for you.

Keep Moving!!

Dr. Sisto

Biologics is the New Buzz Word

Biologics is the new term for the treatment of musculoskeletal injuries utilizing PRP injections or stem cell injections. PRP is “platelet rich plasma” which allows us to draw blood from a patient, spin it down to concentrate the growth factors and inject those factors into an injured knee/shoulder/ankle or elbow joint.
Stem cells are pluripotent cells which means that these are immature cells which can develop into another type of cell if they are introduced into that new cells environment. Stem cells are either harvested from a patient’s bone marrow or fat (autogenous stem cells) or from the umbilical cord of a donor mother who has just given birth (allograft stem cells).
Stem cells have been shown recently to decrease soft tissue inflammation and promote healing of common soft tissue injuries including tendon, muscle and ligament tears. Stem cells have also been shown to decrease the inflammation of degenerative arthritis of the shoulder and knee and give prolonged symptomatic relief. There is no evidence, unfortunately as of yet, that stem cells grow new articular cartilage or reverse the degenerative changes of a joint. Hopefully, the future will be brighter in this battle to reverse the aging of damaged, arthritic joints.
The doctors at The Los Angeles Orthopaedic Institute have been using PRP and stem cells for the past 3 years and are experts at deciding which treatments would benefit specific patients.
Please contact and visit us to discuss if you are a candidate for these new biologics which are keeping patients mobile and living life to the fullest.

Keep Moving!
Dr. Sisto

Stem Cells: Are they right for you?

Biologic factors to enhance healing and treat degenerative arthritis are commonly being performed and our patients are constantly asking the doctors at Los Angeles Orthopaedic Institute if Stem Cells or Platelet Rich Plasma (PRP) are correct for them.

Platelet Rich Plasma (PRP) is performed by taking a blood sample from the patient, spinning the blood down to isolate the growth factors and injecting these cells into the injured joint. The success rate varies depending on the diagnosis and chronicity of the disease. In general, soft tissue injuries including lateral epicondylitis of the elbow (“tennis elbow”), patellar tendonitis of the knee (“jumper’s knee”), iliotibial band tendonitis of the knee (“runner’s knee) and Achilles tendonitis respond best to PRP. Degenerative arthritis of either the shoulder, knee and hip can be significantly helped but the results can vary.

Stem cells are the  New buzz word and there is evolving evidence that they play a role in the treatment of musculoskeletal disease. Adult stem cells have the most promise for use right now and there are two types that are utilized. Both of the types are taken from the patient’s own body. A third type are amniotic cells taken from a donor.

There are advantages and disadvantages of each type but the best information a patient can get is discussing the possibilities with their doctor at Los Angeles Orthopaedic Institute. All of our doctors are experts in Stem Cells and PRP and we will discuss whether these new and exciting treatment modalities will alleviate your pain and increase your mobility.



Sex and Joints

A study presented at the American Academy of Orthpaedic Surgeons recently linked total hip arthroplasty (THA) and total knee arthroplasty (TKA) to IMPROVED SEXUAL FUNCTION!!!
The researchers surveyed 147 patients younger than 75 years old regarding sexual function prior to surgery and one year following surgery. More than 70% reported physical problems prior to surgery.
After surgery 90% of patients reported improved sexual function.
42% reported an improvement in libido, 41% reported increased intercourse duration and 41% reported increased intercourse frequency. Patients also reported improvement in general well-being (84%) and in sexual self image (55%).
Patients with degenerative knee and hip arthritis have had their social, athletic and SEXUAL  lives improved after undergoing a knee or hip arthroplasty (replacement).
At The Los Angeles Orthopaedic Institute we perform more total knee arthroplasties than any other group in the San Fernando, Santa Clarita and Antelope Valleys!!
If you have knee pain and are limited in your athletic, social and sexual life, call us and we can formulate a plan to return you to a more active and romantic lifestyle.
Keep moving (and flirting)!!!

Dr. Sisto

How About A Partial Patellofemoral Joint Replacement?

An article title “Patellofemoral Arthroplasty in Arthritis Patients” was published in the most recent issue of Current Trends from the Department of Orthopaedic Surgery at Mayo Clinic. The authors presented their results of the minimally invasive, partial joint replacement surgery of the patellofemoral joint and they are excellent.  The Mayo Clinic is advocating patellofemoral arthroplasty for isolated arthritis of the patellofemoral joint (“knee-cap”).
I have recently submitted my ten year results of my patients who have undergone a “partial” joint replacement (arthroplasty) of the patellofemoral joint.   My results are fantastic and all of the patients are still satisfied 10 years later and none of them have had any additional surgery.  I will be presenting this paper at The American Academy of Orthopaedic Surgeons Meeting in Chicago March 2013.
Many surgeons will recommend a Total Knee Arthroplasty (replacement) to treat patients with arthritis of the knee.  This is an acceptable treatment but a full knee replacement does have increased complications, more post operative pain and requires a longer recovery time.  A PARTIAL Knee Arthroplasty utilizes a minimally invasive technique, usually a same-day discharge from the surgery center, significantly less post-operative discomfort, less complications and a quicker, more natural recovery.
At the Los Angeles Orthopaedic Institute we specialize in this minimally invasive technique and invite you to consult with us if you have significant knee pain and, especially, if another surgeon has recommended a Full Knee Replacement.  Hopefully, you will be able to undergo a partial replacement and enjoy a much easier recovery and enjoy your minimally invasive surgical experience!
Keep Moving!
Dr. Sisto

PRP Treatment Now Available

A number of new studies have been published discussing the role of Platelet-Rich Plasma in treating patients with degenerative arthritis of the knee. Platelets are found in our blood and are responsible for blood clotting to prevent excessive bleeding. Platelets are also sources of cytokines, which regulate healing and tissue regeneration in the body. The theory of Platelet-Rich Plasma (PRP) therapy is the hope that if a concentrated amount of our own platelets are injected into the knee that it may lead to a healing of the degenerative changes which have occurred in the knee. In essence, it is a process of healing damaged cartilage in the knee.

The surfaces of our bones are lined by a smooth, glistening surface called articular cartilage which allows the bones to glide over each other. The loss of the articular cartilage allows bone to be exposed and the bone on bone grinding causes pain, swelling and stiffness in the knee. This is called degenerative arthritis.

We have been treating a number of patients with PRP in the office with exciting success at short term follow up. The process is done in the office and starts with the patient having a small amount of blood drawn by our staff. The blood is prepared by a special process which concentrates the platelets and other growth factors into a syringe. The “super-healing” concentrate (PRP) is then injected into the knee.

Recent studies in the American Journal of Physical Medicine and Rehabilitation and The American Journal of Sports Medicine have indicated that PRP can be helpful in treating degenerative arthritis.
We are all committed at The Los Angeles Orthopaedic Institute to making our patients’ knees younger and, hopefully, avoiding surgery. Please contact us if you have knee pain and wish to discuss the new non-operative techniques which are now available.

Stay Healthy,
Dr. Sisto

Get Fit with No Pain!

The Wall Street Journal published an interesting article on Tuesday April 12, 2011 titled “Doctors New Advice for Joint Pain is Get Moving.”

The message is that “doctors increasingly are recommending physical therapy to help osteoarthritis patients, overturning the more traditional medical advice for people to take it easy and protect their joints.”

I have always advocated this philosophy and our studies of our patients have shown that weight loss combined with exercises aimed at improving joint function and building up muscles that support the joints can significantly improve patients health and quality of life compared with medication alone.

Mild exercise can be painful at first but, with time, the benefits accumulate as reduced pain and greater mobility. Strengthening the muscles around the knee and shoulder can help support the joints and take over some of the shock-absorbing functions of the cartilage. Regular activity can also replenish lubrication to the cartilage of the joint to reduce stiffness and pain. Aerobic activity such as swimming, walking or cycling which do not put heavy stress on the hips, knees and spine can reduce inflammation in the joints, as well as improving overall fitness and weight control.
I have designed an exercise program which can be started to build up strength and unload the knee joint and reduce knee pain. Please speak to me about this and I can introduce you to our Athletic Trainer, Rick, who can customize a program for you and your musculoskeletal system.

Get Fit with NO PAIN! 

Dr. Sisto