Our Program

The USC Joint Preservation and Replacement Center at Keck Medicine of USC in Los Angeles offers specialized care for the preservation and replacement of the hip and knee, as well as cartilage repair.
Our orthopaedic surgeons provide relief for patients from diagnoses through rehabilitation for conditions such as arthritis, damaged cartilage and hip impingement. Using the latest advances in surgery such as robotic surgery, our surgeons can perform minimally invasive procedures to help speed recovery time.

The USC Joint Preservation and Replacement Center has been recognized as a Blue Distinction Center, a center recognized for its expertise in delivering specialty care by Blue Cross Blue Shield.

Our Approach

We pride ourselves in the ability to provide the appropriate level of care for each specific condition, preserving the joint whenever possible and replacing the joint when necessary. Our program is multidisciplinary and our orthopaedic surgeons work with primary care physicians, anesthesiologists and other subspecialists in the medical field to ensure that our patients are placed in the best path toward success.

Unique aspects of our program include:

  • Pain Management Protocol – Our patients take pain medications prior to undergoing joint replacement procedures, including the morning of the procedure. In addition, pain medication is injected into the joint prior to joint replacement procedures, so that typically, our patients do not feel pain following the procedure. USC orthopaedic surgeons generally use spinal anesthesia rather than general, which is less risky and allows for quicker recovery.
  • Post operative Protocol – In most cases, our patients are in physical therapy the day of surgery, which allows them to go home one or two days after surgery, depending on the treatment given and the patient’s overall health. We’re focused on returning our patients back to an active lifestyle.
  • Physical Therapy – Physical therapists are actively involved in returning you to an active lifestyle. They are involved in the both conservative management of your condition and rehabilitation following surgery. A physical therapy program will be designed to meet your specific need.

Keck Medicine of USC orthopaedic surgeons are among the most experienced in the region, having performed more than 2,000 joint preservation and replacement procedures in the past two years. Staffed by surgeons with specialization in joint preservation and replacement, the center focuses on giving patients the highest level of care.

Arthritis of the knee and hip

Arthritis in Hip

Arthritis is a condition in which one or more joints are inflamed due to the breakdown of cartilage. Without the normal amount of cartilage allowing the joint to move smoothly, bones rub together causing pain, inflammation and stiffness.

For more detailed information about arthritis, click here to view our online health library.

Cartilage damage and repair

Cartilage can be damaged by injury or from wear and tear. Certain treatments and procedures can stimulate growth of new cartilage and may delay or prevent arthritis.

Hip impingement

Hip impingement is a condition where the bones of the hip are abnormally shaped. The bones rub together and cause damage to the joint. Over time, this condition could lead to the development of osteoarthritis.
Rheumatoid arthritis is an autoimmune disease in which the body’s immune system attacks healthy tissue leading to the inflammation of joints and surrounding tissues.

Osteoarthritis of the knee and hip

Osteoarthritis is the most common type of arthritis caused by aging and general wear and tear.

For more detailed information about osteoarthritis, click here to view our online health library.

Osteonecrosis of the knee and hip

Osteonecrosis is a condition in which part of the bone dies from poor blood supply. Though this condition can occur in any bone, it is most common in the hip. Osteonecrosis can be caused by a disease or trauma, but can also develop without a known cause. If the condition is left untreated, patients may develop severe arthritis.

For more detailed information about osteonecrosis, click here to view our online health library.

Patellofemoral arthritis of the knee and hip

Patellofemoral arthritis is arthritis that affects the patella, or kneecap. Patellofemoral arthritis may be due to damage to articular cartilage caused by a kneecap fracture or dysplasia, which occurs when the kneecap does not fit properly causing stress on the cartilage.

Rheumatoid arthritis of the knee and hip

Rheumatoid arthritis is an autoimmune disease in which the body’s immune system attacks healthy tissue leading to the inflammation of joints and surrounding tissues.

For more detailed information about rheumatoid arthritis, click here to view our online health library.

Nonsurgical treatments for arthritis and osteonecrosis

Nonsurgical treatments such as rest from overuse, a gentle physical therapy program, medications such as ibuprofen, enough sleep nightly and weightloss can provide relief for early stages of arthritis and slow progression of the condition. If nonsurgical treatments provide little relief, surgical options are also available.

For those with rheumatoid arthritis, nonsurgical treatments include rest, physical therapy, and medications such as disease modifying antirheumatic drugs, aspirin, ibuprofen, antimalarial medications, corticosteroids and biologic drugs. Surgery may be necessary to correct severely damaged joints.

Arthroscopic cleansing of the knee

Arthroscopic cleansing (debridement) of the knee is intended to treat osteonecrosis by removing damaged or infected tissue to promote healing potential in healthy tissue.

Cartilage grafting of the knee

In this procedure used as a treatment for patellofemoral arthritis, surgeons take healthy cartilage from another part of the knee to fill a hole in the damaged cartilage.

Chondroplasty treatment of the knee

Chondroplasty is performed via arthoscopy for patients with mild to moderate patellofemoral arthritis. The surgeon trims and smooths arthritic surfaces in the joint.

Core decompression procedure for the hip

This procedure, used to treat osteonecrosis, involves removing part of the inside of the bone to relieve pressure in the bone and create channels for new blood vessels to nourish the affected areas of the hip. If osteonecrosis is treated early enough, this procedure may prevent the bone from total collapse.

Partial knee replacement surgery

Partial knee replacement surgery may be a good option for those suffering from pain caused by advanced arthritis or osteonecrosis. In partial knee replacement surgery, surgeons only remove and replace the area of the knee that is damaged. For more detailed information about partial knee replacement surgery, click here to view our online health library.

Realignment of the knee

In this procedure used as a treatment for patellofemoral arthritis, tissues surrounding the kneecap are either tightened or released to change the position of the kneecap.

Tibial tuberosity transfer treatment of the knee

The tibial tuberosity is the bump on top of the shinbone and is connected to the patellar tendon. Shifting the bump changes the kneecap’s position relieving pressure on areas affected by patellofemoral arthritis.

Total knee replacement surgery

Patients whose knees have been damaged due to arthritis, osteonecrosis or an impactful injury and are experiencing negative impacts to their quality of life may elect to have total knee replacement surgery. Surgery is usually an option after nonsurgical approaches such as rest, medication, and physical therapy, are no longer helpful.

For more detailed information on knee replacement surgery, click here to view our online health library.

Vascularized fibula graft procedure for the hip

In this procedure, used to treat osteonecrosis, a segment of bone is taken from the small bone in your leg along with an artery and vein and transplanted into a hole created in the femur. The artery and vein are reattached to help heal the area lacking adequate blood supply.

This procedure is used when the condition has advanced and the femoral head has collapsed. Artificial impants are used to replace damaged bone and cartilage.

For more detailed information on total hip replacement, click here to view our online health library.

Cartilage Repair and Joint Preservation

Surgeons can perform a variety of procedures to stimulate growth of new cartilage to alleviate pain, allow better function and delay or prevent arthritis.

  • Abrasion Arthroplasty
    Abrasion arthoplasty is a procedure similar to drilling, but high-speed burrs are used to remove damaged cartilage.
  • Autologous Chondrocyte Implantation
    In this procedure, healthy cartilage is removed from the bone and cultured to increase over a three to five week period. In a second procedure, the newly grown cells are implanted.
  • Drilling
    Like microfracture surgery, drilling stimulates the production of new cartilage via the creation of small holes in the bone in the damage area with a surgical drill or wire.
  • Microfracture surgery of the knee
    In this common procedure, the surgeon makes small holes, or microfractures, in the bone near the damaged cartilage. The microfractures release cells in the bones that build new cartilage.
    For more detailed information about knee microfracture surgery, click here to view our online health library.
  • Osteochondral Autograft Transplantation
    In this procedure, cartilage is transferred from one part of the joint to another. This procedure is typically used for smaller areas of cartilage damage.
  • Osteochondral Allograft Transplantation
    If the damaged cartilage is too large for an autograft, an allograft, or graft from a donor may be transferred.

Orthopaedic Physical Therapy

Our orthopaedic physical therapists use specialized skills to assess and treat musculoskeletal injury and illness, prevent pain or further damage, train different muscles to compensate for ones that have been damaged and, ultimately, restore the patient’s ability to work, play and live as normally as possible. Orthopedic physical therapy is provided on an inpatient and outpatient basis by therapists who are certified in this specialty. This means that they not only are licensed physical therapists, but also have met rigorous national standards of education, experience and clinical expertise in the specialty of orthopedics.

Orthopaedic physical therapy can benefit patients with a wide range of injuries or disorders, including:

  • Post-operative joint replacement
  • Hip and/or pelvic pain
  • Arthritis (osteoarthritis and rheumatoid arthritis)

After a thorough assessment to identify the source of your pain or mobility problem, we will design a treatment program tailored to your unique needs, utilizing a range of treatments. For more information, click here.

Support Information

American Academy of Orthopaedic Surgeons
http://www.aaos.org

American Orthopaedic Foot and Ankle Society
http://www.aofas.org

American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine
http://www.isakos.com

Orthogate – The Gateway to the Orthopaedic Internet
http://www.orthogate.com

Our Physicians

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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2

Specializing In

Joint Replacement of the Hip and Knee

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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
USC Verdugo Hills Hospital

Specializing In

Joint Replacement of the Hip and Knee, Partial Knee Replacement

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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
USC Outpatient Surgery Center

Specializing In

Arthroscopic Knee Surgery, and ligament reconstruction (ACL Surgery), Arthroscopic Shoulder Surgery (rotator cuff shoulder instability), Cartilage Preservation, Knee Osteotomy, Total and Reverse Shoulder Replacement

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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2

Specializing In

Joint Replacement of the Hip and Knee, Degenerative Arthritis of the Hip and Knee, Osteonecrosis of the Hip and Knee

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Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2

Specializing In

Joint Replacement of the Hip and Knee

view profile

Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2

Specializing In

Joint Replacement of the Hip and Knee

view profile

Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
USC Outpatient Surgery Center

Specializing In

Shoulder and Elbow Surgery, Total Elbow Replacement, Total and Reverse Shoulder Replacement, Hip Arthroscopy

view profile

Practicing Locations

Keck Hospital of USC
USC Healthcare Center 2
USC Outpatient Surgery Center

Specializing In

Arthroscopic Knee Surgery and Ligament Reconstruction (ACL Surgery), Arthroscopic Shoulder Surgery (Rotator Cuff, Shoulder Instability), total and reverse shoulder replacement, cartilage preservation procedures.

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Practicing Locations

USC Healthcare Center 2
USC Outpatient Surgery Center

Specializing In

Cartilage Preservation; Arthroscopy and open surgery of the Knee, Shoulder and Elbow

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Practicing Locations

Keck Hospital of USC
Keck Medicine of USC – 1808 Verdugo Blvd.
USC Healthcare Center 2
USC Outpatient Surgery Center
USC Verdugo Hills Hospital

Specializing In

Arthroscopic Knee Surgery and Ligament Reconstruction (ACL Surgery), Arthroscopic Shoulder Surgery (Rotator Cuff Shoulder Instability), total and reverse shoulder replacement, cartilage preservation procedures, and Hip Arthroscopy