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

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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

Minimally Invasive Rotator Cuff Repair

The rotator cuff tendons of the shoulder function to raise our arm and allows us to perform activities as exciting as throwing baseballs and shooting baskets as well as merely combing our hair without pain or discomfort. Tendons are structures which connect muscle to bone and they are like pulleys which raise and rotate our shoulders. In normal, pain free shoulders the tendons glide under the bony roof of the scapula and allow us to perform over-the-shoulder activities pain free.
The tendons, however, can tear secondary to trauma such as a fall onto the shoulder or they can tear secondary to overuse and cause pain and weakness of our shoulder.
The treatment of a rotator cuff tear is surgical and we perform minimally-invasive arthroscopic techniques to repair the rotator cuff. These mini-incisions cause MUCH LESS discomfort and the recovery following surgery is much faster and more dependable.
Please contact us if you have shoulder pain and certainly contact us if another orthopaedic surgeon has recommended a rotator cuff repair to see if you are a candidate for a minimally invasive arthroscopic rotator cuff repair.

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

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

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