Autogenous Patellar Tendon Graft for ACL’s

The autogenous patellar tendon graft is the gold standard for anterior cruciate ligament (ACL) reconstruction of the knee.  Two new studies just published in the prestigious American Journal of Sports Medicine have confirmed that the autogenous (the patient’s own) patellar tendon graft is superior to the autogenous hamstring graft. The results were quite dramatic as patients with hamstring tendon grafts had TWICE the risk of revision compared with patients with patellar tendon grafts!! Younger age was the most important risk factor for revision, and no effect was seen for sex.

We routinely recommend the autogenous patellar tendon graft in competitive athletes 40 years of age and younger. The procedure is difficult to do and that is why other orthopaedic surgeons do not perform it BUT the results are superior to any other ACL reconstructive procedure.

Please call us if you have any questions about ACL reconstruction and which procedure would be best for you!

Keep Moving!

Dr. Sisto

Happy New Year

Wishing all of our patients a happy & healthy New Year!

Demand Your Own Ligament!

A tear of the anterior cruciate ligament (ACL) is a disabling athletic/work place injury which, untreated, could lead to knee instability, pain and degenerative arthritis.  The treatment of an ACL tear is surgical and requires “harvesting” another ligament in the knee to reconstruct the torn ACL.  The long term results are in the 95% success range but there can be anterior knee pain known as “harvest site morbidity.”

Surgeons have attempted to avoid this small, relatively insignificant complication by utilizing a “cadaver allograft” which is a ligament taken from a dead person, secondarily sterilized and inserted in the knee.

The advantages of allograft are that it avoids “harvest site morbidity” and it is a technically much easier surgery to perform. Harvesting a patient’s own patellar tendon or hamstring graft is a more delicate procedure and is performed only by “knee specialists” and those knee surgeons who have done a knee fellowship and perform at least 100 ACL reconstructions a year.

The PROBLEM is that allografts ABSOLUTELY DO NOT give the same results as an “autograft” or using the patient’s own tissue as a graft!!

A recent study in The American Journal of Sports Medicine confirmed that allografts had a MUCH HIGHER incidence of failure at 5 year follow-up.  This was one of a number of studies which have all shown A MUCH HIGHER RATE of failure with ALLOGRAFT.

I am the Team Physician for Cal State University Northridge (CSUN), Pierce, Mission and Antelope Valley colleges, The Lancaster Jet Hawks and Chaminade High School and I only utilize autografts in these high level athletes who cannot risk a recurrent injury!

If you or a friend have torn their ACL and your doctor has recommended an allograft, ABSOLUTLEY GET A SECOND OPINION and get the facts of autografts vs allografts!

Every risk level athlete who has recently torn their ACL (Adrian Peterson, Robert Griffin, Derrick Rose, Rajon Rondo) have all had autogenous patellar tendon graft ACL reconstructions.  This is the best option and the surgery that is RIGHT FOR YOU as well.

 

Keep Moving!
Dr. Sisto

Congratulations Northridge Hospital

Kemp.H-education

Congratulations to Northridge Hospital Medical Center for being designated a Blue Distinction Center for Knee and Hip Replacement by Anthem Blue Cross and Blue Shield of California. This national designation is given to medical facilities that have demonstrated expertise in delivering quality specialty care in comprehensive in patient knee and hip replacement services.

The reason I am excited about this award is that Blue Destination Centers have a proven track record for delivering better results including fewer complications and re-admissions than hospitals without these recognitions.

I have been on staff at Northridge Hospital for twenty five years and have performed over one thousand knee arthroplasties at this great hospital. I am proud of this distinction and invite you to discuss the advantages of having a partial or total knee arthroplasty at Northridge.

Keep Moving!
Dr. Sisto

Everything Old is New!

Everything Old is New Again!

Cole Porter 1930
You may have seen multiple advertisements telling you that you should have a robotic-assisted total knee arthroplasty (replacement) to improve your result. These ads were paid for by hospitals that are attempting to convince you that a robot or computer assisted surgery is an improvement and will maximize your result.
The TRUTH, however, is that mulitple studies have confirmed that patients who have had computer navigation have the same results as those who have the surgeon perform the essential aspects of the surgery. All of these studies have shown that there was no difference in clinical function, alignment, and survivorship of the components between the computer-navigated and conventional or traditional total knee arthroplasties.

The hospitals that are advertising the beneficial effects of computer or robotic navigation are tricking you into paying more money travelling a greater distance to have a total knee arthroplasty when there is ABSOLUTELY NO EVIDENCE that a computer or robotic surgery is better.

The Los Angeles Orthopaedic Institute performs more total knee arthroplasties than any other group in the San Fernando, Santa Clarita and Antelope Valleys. Our surgeons have over 25 years experience in mastering the surgical techniques as well as catering to every one of your concerns to maximize your result.

Trust us to take you through this difficult journey and we will get you back to a more youthful and athletic lifestyle to allow you to enjoy our NEW knee.

If you have knee pain and have been told you may need a knee surgery, please call us to discuss the best option for you to MAXIMIZE your results.

Keep Moving!!
Dr. Sisto

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

Springtime

SPRINGTIME has arrived and the best aspect of April is the beginning of the new baseball season! Baseball diamonds are alive throughout the San Fernando, Santa Clarita and Antelope Valleys and high school and college athletes as well as weekend warriors are enjoying Americas Past-time!
The ecstacy of hitting the ball and running the bases and, possibly, sliding into home plate exceeds the enjoyment of any other sport. Hitting a home-run to end the game and jumping on home-plate is a DREAM COME TRUE which is possible no matter what level of baseball you play.
Unfortunately, injuries are a part of the game and the shoulder, elbow and knee are the most vulnerable areas to be effected.
 Fortunately,  however, the orthopaedic surgeons at The Los Angeles Orthopaedic Institute take care of the most elite baseball players in our area and will take care of the injured athlete and maximize their return to baseball.
We are the team orthopaedic surgeons for Cal-State Northridge University (CSUN) which means that we are the only doctors taking care of elite Division I scholarship baseball players in the San Fernando, Santa Clarita and Antelope Valleys. We are the only surgeons that CSUN would trust to operate on those scholarship athletes many who go on to play professional baseball!!
We also care for the baseball teams for Pierce College, Antelope Valley College and Mission College as well as many of the high schools in the Tri-Valley area! We are also the team physicians for the Lancaster Jethawks which is the minor league team for the professional Houston Astros organization.
If you love baseball as much as we do and are injured, please call the baseball orthopaedic specialists at The Los Angeles Orthopaedic Institute to be treated as well as our elite scholarship and professional baseball players!!

Keep Playing!

Dr. Sisto

“Breakthrough” – We’ve Been Doing for 5 Years

LA_knee_surgeryThere has been an explosion of radio, televsion and newspaper advertisements announcing a “breakthrough” in non-operative treatment of the knee. These centers claim that they are offering a “new, innovative treatment” for knee arthritis which is NOT available at other doctors offices.
This is obviously false advertising and the Knee Centers should be ashamed of themselves.
All they are offering is a routine treatment which we have been routinely performing at the LOS ANGELES ORTHOPAEDIC INSTITUTE for the past FIVE YEARS.
We have been injecting a high molecular weight Hyaluronan into the knee to “oil” the joint and replace the natural lubrication which is missing in patients with degenerative arthritis. We use either ORTHOVISC or SUPARTZ which are both FDA-approved, non-drug therapy made from ultra-pure hyaluronan. It restores the natural joint fluid (hyaluronan) that cushions, protects and lubricates your knee joint. With better cushioning, your knee can move and function better.
Hyaluronon injections are indicated for patients with mild, moderate and severe degenerative arthritis.
At the Los Angeles Orthopaedic Insititute we have injected thousands of knees with many repeat patients who have been able to return to most if not all of their prior activites WITHOUT SURGERY!
Please call us if you have been told that you have degenerative or osteoarthritis of the knee and have been told you may need surgery. We can determine the BEST treatment for you and, hopefully, begin a series of Hyaluronan injections and start you moving your knees as soon as possible.
Keep Moving!

Dr. Sist0

Fifth Straight Year!

The 2013 Southern California SUPER DOCTORS issue of Los Angeles Magazine has just hit the newstands and I am happy and proud to announce that I have been selected.  This is the fifth straight year I have been chosen and it is particularly gratifying because we are chosen by our PEERS. This means that most of the orthopaedic surgeons in Los Angeles selected me to be on this small and prestigious list. In fact, I am the ONLY orthopaedic surgeon from the Antelope Valley on the list and one of only a few in the San Fernando and Santa Clarita Valleys as well.
I believe the main reasons I am always selected to the SUPER  DOCTOR list include the fact that I am the team physician for Cal State Northridge (CSUN) athletes. I am the ONLY orthopaedic surgeon in our three valleys that operates on elite, scholarship athletes. There are only a few Division I athletic programs in Los Angeles (UCLA, USC, CSUN, Pepperdine, Loyola Marymount) and the school officials, athletes and athletic trainers trust me to perform the surgery on these gifted athletes who MUST return to the same level of play prior to their injuries!
The second reason I am selected is that I specialize in minimally invasive, PARTIAL joint replacements which allow the patients to recover much quicker with less discomfort.
I am proud to be selected again to be one of the SUPER DOCTORS of Southern California and I look forward to taking care of you and your family when I am needed.

Keep moving!
Dr. Sisto

ACL Tears – Autografts vs. Allografts

Tears of the anterior cruciate ligament of the knee are devastating injuries and, unfortunately, are on the rise in incidence. There are many factors to explain this but the increase is primarily among female athletes.
The treatment of a torn ACL is surgical in young patients and in older athletes who do not want to stop competing and enjoying sports.
Two recent events have occurred which verifies that the surgical procedures done by the surgeons at The Los Angeles Orthopaedic Institute are the BEST to reconstruct the ACL.
Two long term studies have just verified that allografts are inferior compared to autografts to reconstruct a torn ACL. Allografts are tissue from a cadaver (dead body) and an autograft is from the patients’ own body. The advantages of an allograft are smaller incisions and less pain in the first week post-operatively. The disadvantage, however, is a higher FAILURE rate which is unacceptable.
We have always known that autografts are superior and we have ALWAYS recommended autografts to our athletes!
The choice of autografts is either the patients’ patellar tendon or the hamstrings. We have always preferred the patellar tendon for THREE main reasons.
#1 – The patellar tendon has bone on either side and we get bone to bone healing which is the quickest and strongest graft!
#2 –  The patellar tendon is the strongest graft!
#3 –  We do not want to sacrifice the hamstring tendons as this leads to knee weakness and stress on the reconstructed knee.
Adrian Peterson, the elite running back for the Minnesota Vikings just returned from ACL surgery and had his best running year ever. Of course he had a patellar tendon autograft which is what we have been performing in our patients over the past twenty years.
The Los Angeles Orthopaedic Institute surgeons are the orthopaedic surgeons for Calstate Northridge (CSUN) which are the only Level I Scholarship Athletes in all of the San Fernando, Santa Clarita and Antelope Valleys. The most elite athletes, coaches and trainers have selected us to perform these surgeries on their athletes for over 15 years!
We hope you maintain healthy knees but if you or a friend tears the ACL we should be your FIRST CHOICE!

Stay Healthy,
Dr. Sisto