Orthopaedics and Sports Medicine

Whether you’re an elite athlete with a knee injury or a retiree who wants to garden without pain, St. Jude Heritage Orthopaedics and Sports Medicine offers the most innovative and advanced care available today.

Our nationally-recognized physicians are using dramatic improvements in care to successfully treat a wide range of conditions – from injuries to arthritis - allowing our patients to get back to doing the things they love.

With degrees and training from the top orthopaedic programs - including Harvard, UCLA, Yale, Cornell and Stanford - our fellowship-trained specialists provide cutting-edge diagnosis and treatment. In fact, in areas from cartilage restoration to sophisticated non-surgical interventions, we offer a level of expertise that places us among Southern California's best.

Our highly-trained experts include:

Raed Ali, M.D.
Donald E. Bittner, M.D.
Andrew Concoff, M.D.
Karen Evensen, M.D.
Andrew C. Karich, M.D.
Kevin Khajavi, M.D.
Eric L. Lin, M.D.
Stewart L.Shanfield, M.D.
S. Shawn Solhpour, M.D.
Allen Tham, M.D.

Cartilage Restoration

We offer one of the nation's leading experts in successfully treating and repairing cartilage damage and its resulting joint pain. Fellowship-trained in sports medicine as well as cartilage restoration, our orthopaedic surgeon is at the forefront of cartilage repair and transplantation – and is using these cutting-edge techniques to bring dramatic benefits to athletes, weekend warriors and baby boomers with active lifestyles.

Here you'll find today's most exciting advances to repair, preserve and replace damaged cartilage in the knee – often preventing the onset or progression of arthritis. In some cases, cartilage restoration can also successfully treat joint problems in the shoulder and ankle, offering an important alternative to joint replacement.

By significantly reducing or eliminating pain in the joint, these biologic resurfacing techniques help patients return to an active lifestyle and regain their quality of life.

Specialized Services

• Arthroscopic debridement
  Aided by a tiny camera (arthroscope) and using very small incisions, torn or damaged cartilage is located and trimmed away – reducing pain and restoring function.
• Arthroscopic microfracture
  By creating small holes in the bones, microfracture stimulates the growth of cartilage – using the body's own healing abilities to repair cartilage defects. Successfully used to treat cartilage damage in both the knee and shoulder.
• Cartilage cell transplantation (ACI procedure)
  Cartilage cell transplantation is one of the newest and most exciting developments in successfully treating knee joint pain. A patient’s own cells are harvested and grown in a laboratory culture. In a second procedure, the cells are re-implanted in the knee to repair and resurface areas where there’s been cartilage loss. Available at fewer than 50 medical centers in the country, ACI procedures allow us to restore mobility and range of motion without using an artificial joint in both the knee and shoulder.
• Cartilage “plugs” (OATS procedure)
  Used to successfully treat isolated areas of cartilage damage, a small section of the patient’s own bone and cartilage is removed from an area that does not bear weight to serve as donor cartilage. The donor bone and cartilage is then transferred to the damaged part of the knee being repaired.
  For larger areas of bone and cartilage loss, our surgeons can implant a piece of donated cartilage and bone that eventually functions as the patient’s own tissue. The OATS procedure is typically used only on active individuals under 50 who have cartilage injuries and premature arthritis.

Foot and Ankle

The foot and ankle are subject to constant stresses and hazards, from the effects of arthritis to traumatic sports injuries. Fellowship-trained in foot and ankle surgery, our orthopaedic specialist offers surgical and non-surgical treatments for a wide range of foot and ankle problems, including injuries, fractures, arthritis and deformities. From simple conditions to the most complex ankle reconstruction, we are experts in relieving pain and helping patients regain their quality of life.

Areas of expertise include:

• Arthroscopic repair of conditions from ligament tears to cartilage damage
• Foot and ankle reconstruction, including successful repair of flatfoot, bone deformities and arch problems
• Forefoot reconstruction
• Fracture care
• Repair of cartilage injuries, including cartilage transplant and regeneration
• Total ankle joint replacement, allowing natural pain-free motion
• Treatment of ankle instability, including anatomic reconstruction, ligament repair or tendon grafting
• Treatment of tendon disorders, including tendon repair and reconstruction

Specialized Services

Sports Injuries

The foot and ankle are the most commonly injured joints in recreational and elite athletes. Injuries can range from ankle sprains and stress fractures, to nerve, ligament, and tendon damage. Many injuries can be effectively treated without surgery. For more serious or complex injuries, minimally-invasive surgical techniques are creating improved outcomes and dramatically shorter recovery times.

Ankle Arthritis

Because the ankle absorbs the body's full impact, pain from rheumatoid or trauma-related arthritis can be especially severe and debilitating. For many people suffering from an injured or diseased ankle, ankle replacement surgery can eliminate the pain and help them return to everyday activities. Using the newest techniques and materials, our board-certified foot and ankle surgeon replaces the injured ankle joint, allowing a natural, pain-free motion.

Not every patient is a good candidate for ankle replacement. For some, ankle fusion – where the damaged joint cartilage is removed and the bones around the ankle knit together into a solid painless structure – will offer better outcomes.

Medical Conditions

Health issues such as nerve and circulatory disorders, cerebral palsy, diabetes and stroke can create pain, weakness and deformity in the ankle and foot. Aggressive prevention and treatment allows our orthopaedic specialist to correct muscle imbalances, and prevent foot deformities from becoming permanent. For some conditions, bracing and physical therapy alone can be successful. In other cases, surgery – including tendon transfer or tendon lengthening – can help realign the foot and allow normal movement.

Hand and Wrist

We offer one of Southern California's most respected hand specialists, which means here you'll find comprehensive diagnosis and treatment of injuries to the bones, tendons and nerves of the hand, wrist and forearm.

Our fellowship-trained orthopaedic hand surgeons routinely uses the newest advances in arthroscopic and microsurgical techniques to successfully treat nerve compression syndromes, arthritic conditions and traumatic injuries. We also offer today's most effective approaches to fracture care, joint replacement and tumor removal.

Areas of expertise include:

• Open and arthroscopic carpal tunnel release
• Microsurgical reconstruction, including free tissue (muscle or bone) transfer and the correction of congenital hand deformities
• Arthroscopic treatment of joint loose bodies, arthritis, tendon injuries and fractures
• Replantation and revascularization of amputated or injured parts, including microvascular free flap coverage
• Joint replacement for treatment of arthritis of the elbow, wrist and fingers
• Surgical treatment of benign and malignant tumors, including soft tissue and tumors of bone
• Advanced fracture care, including the use of bone graft substitutes

Specialized Services

Hand Therapy

Therapy often plays an important role in the treatment or rehabilitation of a wide variety of hand and upper extremity injuries and conditions. Our patients benefit from highly experienced occupational and physical therapists who specialize in the successful rehabilitation of the hand, wrist and forearm.

Our certified hand therapists offer the experience, training and specialized skills necessary to help patients recover and regain function as quickly as possible. Located within the St. Jude Center for Rehabilitation and Wellness, our experts offer individualized treatment based on each patient's needs and goals.

Joint Replacement and Reconstruction

Joint deterioration from arthritis or injury can make even the simplest activities painful. Yet recent improvements in surgical techniques and technology are making joint replacement an increasingly popular and effective solution – allowing many to regain active, healthy lives.

Within St. Jude Heritage Orthopaedics and Sports Medicine, you’ll find some of the nation’s leading experts offering today's most advanced joint replacement options. Having performed thousands of successful joint replacements, our surgeons’ expertise and experience allow them to individualize the procedure, technique and materials to fit your needs. In fact, our nationally respected surgeons are leaders in creating remarkable patient outcomes.

We're pleased to offer our patients the newest surgical approaches to joint problems, including:

• minimally-invasive knee and hip replacement
• partial knee replacement in which only the most damaged areas of cartilage are removed and replaced
• total joint replacement for shoulder and ankle
• shoulder and hip resurfacing
• joint reconstruction surgery, including complex revision surgery
• advanced arthroscopic techniques

Specialized Services

Partial Knee Replacement

At St. Jude Heritage you'll find highly experienced experts in total knee replacement as well as newer, minimally-invasive partial knee replacement. Unlike a total replacement in which all three compartments of the knee are replaced, a partial knee replacement removes only the damaged or diseased areas while preserving healthy bone and cartilage. This minimally-invasive resurfacing technique also preserves the tendons and ligaments around the knee. Ideal for those whose arthritis or knee damage is confined to a limited area, our surgeons are using this advanced technique to produce exceptional results, including a more normal knee motion, better range of movement and an accelerated recovery. Considered an outpatient procedure, partial knee replacement often requires only an overnight hospital stay.

Shoulder

Over the last decade, significant advances have been made in the treatment of shoulder conditions – and here you'll find those advances being used to benefit our patients every day. Our comprehensive services include the entire range of orthopaedic and sports medicine care: from the latest surgical interventions to state-of-the-art rehabilitation designed to accelerate recovery.

Our fellowship-trained experts are using new breakthroughs – such as reverse shoulder replacement – to successfully help patients whose injuries were once considered beyond repair. Equally important, new minimally-invasive techniques – including arthroscopic rotator cuff repair and arthroscopic reconstruction for instability – are allowing us to dramatically reduce recovery times.

From common overuse injuries to the most complex reconstruction and revision surgeries, our highly experienced orthopaedic and sports medicine surgeons are creating outstanding outcomes for patients of all ages.

Frequently treated conditions include:

• rotator cuff injury
• shoulder impingement (bursitis)
• dislocations
• labral tears
• shoulder instability
• shoulder separation (acromioclavicular joint injury)
• fractures
• overuse injuries
• frozen shoulder (capsulitis)

Arthroscopic Rotator Cuff Repair

Our orthopaedic surgeons specialize in one of the newest and most important advances in the treatment of rotator cuff tears: arthroscopic repair. For many of our patients, this minimally-invasive, outpatient procedure is making a significant difference in comfort and recovery while offering outstanding clinical outcomes.

Instead of the traditional open surgery or mini-open approach in which muscle is detached, delicate arthroscopic instruments and techniques allow our surgeons to successfully repair this common injury through three to four very small puncture wounds. By preserving the deltoid muscle, most patients experience better range-of-motion, accelerated rehabilitation, as well as less pain and scarring.

Reverse Shoulder Replacement

For those with a torn rotator cuff and shoulder arthritis, simply raising their arm can be extremely painful, if not impossible. A new and innovative shoulder replacement surgery features a reverse ball/socket technique that can dramatically lessen pain and improve function – even for patients with extensive rotator cuff damage, instability or a previous failed surgery.

In the healthy shoulder, the upper arm bone (humerus) ends in a ball shape which fits into a socket formed by the shoulder blade (scapula). With a reverse shoulder replacement, the anatomy, or structure, of the healthy shoulder is reversed: the ball portion is attached to the scapula and the socket is placed at the upper end of the humerus.

By reversing the ball and the socket, the deltoid muscle (the large shoulder muscle) becomes more efficient and often compensates for the torn rotator cuff – allowing patients to regain their range of motion and quality of life.

Specialized Services

Ultrasound-Guided Needle Tenotomy

Double-Bundle ACL Repair

Minimally-Invasive ACL Repair

No-Incision All-Inside ACL Repair

Sport-Specific Injury Prevention

Want to prevent an injury from taking you out of the game? Sport-specific conditioning (often called “prehabilitation”) is one of the newest and most important trends in sports today – allowing you to reduce your risk of injury while also improving performance.

Every sport has common injuries, from knee injuries in soccer to shoulder injuries in baseball. Our prehabilitation program uses sport-specific exercises and drills especially designed to prevent those injuries and improve your game.

Whether you are a junior high student playing club sports or a professional athlete, our innovative sports-conditioning program can help you:

• increase sport-relevant strength
• maintain proper posture and position for joint motion
• improve muscle stabilization
• avoid at-risk positions
• use muscle groups in sports-specific sequence
• boost the efficiency of movement patterns essential to your sport
• train high-velocity movements (plyometrics)

Call us to learn more about the competitive advantage prehabilitation can offer you.

Trauma

Our fellowship-trained orthopaedic surgeons offer state-of-the-art treatment and follow-up care for adult and pediatric trauma cases. Offering the expertise of nearly a dozen different orthopaedic subspecialties, we successfully treat the entire range of traumatic injuries, from simple isolated fractures to the most complicated orthopaedic emergencies.

Leading edge techniques – including minimally-invasive surgery, advanced external fixation, and the use of bone graft substitutes and bone-forming proteins – allow us to create superior outcomes for our patients. We also successfully treat the after-effects of traumatic injuries, including nonunions (fractures that do not heal), bone infections, and arthritis.

Our highly skilled team specializes in the following services and injuries:

• minimally-invasive fracture stabilization
• joint dislocations and ligament injuries
• complex soft tissue reconstruction
• complex fractures of the upper and lower extremity
• minimally-invasive bone grafting
• spine trauma
• post-traumatic arthritis
• acetabular fracture care
• infected fractures and osteomyelitis
• treatment of nonunions and malunions (fractures that do not heal in the correct alignment)