Of Mice and Men

The big scientific news this week was the research done at Stanford and Harvard where older mice were injected with the blood of younger mice. The older mice significantly improved their mental functions and added significant amounts of muscle mass.

The airwaves have been rocking with this news as it heralds the possibility of delaying and, eventually, reversing the aging process. The Fountain of Youth may be in our not too distant future.

Of course, the study was preliminary and in mice and human trials have not been done BUT the researchers have identified the protein factor in the young blood that they believe is the active factor. It is a growth differentiation protein which stimulates stem cells to differentiate into new, fresh cells throughout the body. Stem cells are those that are pluripotential meaning that they can become many different types of cells depending on the environment they are placed in. There is exciting early work being done in the knee which may allow us to eventually replace meniscus and articular cartilage!

At the Los Angeles Orthopaedic Institute we are committed to restoring cartilage and making our patients’ knees as young as possible. We routinely perform Platelet Rich Plasma (PRP) injections, Hyalgan injections and perform mini invasive surgeries to keep the knees young and active. Please call us to discuss these exciting new treatments to keep everyone active and mobile!

After all, if mice can do it so can we!

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

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

There 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

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

ACL Tears

Mariano Rivera, the star pitcher of the Yankees, and Derrick Rose, the top point guard in the NBA, both recently tore the Anterior Cruciate Ligament (ACL) which is the main stabilizing ligament of the knee. Their notoriety has thrust the importance of the ACL into the national headlines but for thousands of athletes all over the country an ACL tear is a common and serious injury to their own knees.
We are the Team Physicians for Cal State Northridge (CSUN), Antelope Valley and Mission Community Colleges. In addition, Chaminade and Milken High Schools as well as the Lancaster Jet Hawks which is the Single A affiliate of the Houston Astros professional baseball team. We have taken care of many high school athletes with torn ACL’s and we recognize the magnitude of the injury and the program which is required to overcome the surgery and return to the same level of athletic performance.
ACL injury is extremely common with more than 100,000 ACL reconstructions performed annually in the United States. The majority of the ACL injuries occur in athletes but work and auto accidents also are common. Associated injuries include meniscus tears (the shock absorber of the knee) and bone contusions.
An untreated ACL tear will lead to an unstable knee and there is an increased incidence of additional injury to the knee if surgery is avoided. Patients who participate in aggressive cutting and pivoting sports, such as basketball, soccer, volleyball, lacrosse and tennis have a high rate of recurrent instability without ACL reconstruction. In view if this, athletic patients who choose to return to these sports generally undergo surgery soon after the injury.
The technique for ACL reconstruction involves placing a free tendon graft in the anatomic position of the ACL. The tendon graft can be taken from the patient’s injured knee or from a donor. All graft choices have advantages and disadvantages.
We perform over 200 ACL reconstructions each year at our Sports Center at The Los Angeles Orthopaedic Institute. We take care of the most elite athletes in Southern California. If you have an ACL tear, please contact us for an in-depth discussion of which treatment option will be best for you to maximize your recovery and return to your highest level of athletic performance.
 

Top Doctor Award

I have been selected as one of the TOP DOCTORS in Los Angeles for the third straight year. This is a prestigious award as the TOP DOCTORS are voted in by their peers which is the highest source of praise>

There are a number of reasons which contributed to my selection and I believe that my specialty in minimally invasive surgery of the knee and shoulder is my most significant contribution to my peers and to my patients. I have published multiple peer-reviewed articles on PARTIAL ARTHROPLASTY (Replacement) of the knee and, in fact, will be presenting our ten-year results of partial knee arthroplasty at the Academy Meeting in San Francisco in February. Our ten-year survivorship is 100% and my implant design and techniques have been shared with all of the other orthopaedic surgeons in the country who now utilize this procedure. My peers have benefited from my research and my patients have certainly benefited as well.

Please call me if you have been told by another orthopaedic surgeon that you require a total knee arthroplasty. You may, in fact, be able to undergo a PARTIAL KNEE ARTHROPLASTY which has a much quicker recovery time and a much lower complication rate. The post-operative pain is much less and the results are superior as well.

Please contact me if you have knee pain and your life has been altered by pain and a restriction of activities. A more youthful knee is definitely in your future!

Stay Active!
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

Who’s Who Recognition

I was just selected into Marquis Who’s Who in Medicine and Healthcare in 2011-2012.  This is the publisher of the Who’s Who in America since 1899.  This award distinguished me as one of the leading healthcare professionals from around the world.

I was told that I was selected because I have developed a minimally invasive surgical procedure to grow “new cartilage” in the knee to make the knee “young again”.

I am proud of this recognition and I encourage anyone who has knee pain and is disabled because of pain to be evaluated and we can recommend a minimally invasive surgical procedure to eliminate years off the knee and allow you to function at a higher level.

I am proud of this recognition by the Who’s Who of America and I look forward to treating all of your knees in the years to come.

Dr. Don

New ACL Technique

The anterior cruciate ligament (ACL) is the prime stabilizer of the knee to prevent anterior instability. Ligaments are the “ropes” of the knee which connect bone-to-bone and stabilize the knee. When ligaments tear the two ends spring apart like a “torn guitarstring” and the ligament loses its blood supply and it dissolves. The patient will have an unstable knee without an ACL which can lead to a meniscus tear and early degenerative arthritis of the knee.
The reconstruction of an ACL tear utilizing the patients own tendons  (structures which connect muscle to bone) or a allograft (cadaver donor) is a successful procedure but one that, unfortunately, does not prevent and may accelerate the development of early degenerative arthritis. The reason for this is that in the past we have used a Trans-Tibial technique to perform our drill holes in the bone to stabilize the ligament. This technique cannot put the ACL graft back to its “Anatomic Footprint Position” and will change the function (kinematics) of the knee which will lead to early arthritis.
A new technique has been devised to create our bone tunnels in the femur and tibia at the “Anatomic Footprint Position” which enhances stability and restores the normal kinematics of the knee and prevents the development of early arthritis.
We routinely use this new “Anatomic” ACL reconstruction and our results have been fantastic! If you have an ACL tear, ask your surgeon if they use the new “Anatomic reconstruction technique” and if they do not, get a second opinion with us to discuss the new technique and how it will improve the long-term outcome of you surgical result!

Keep moving!
Dr. Sisto