Scheinberg Orthopedic Group

Sports medicine is a subspecialty of orthopedics that deals with the prevention, diagnosis, treatment and rehabilitation of injuries suffered during athletic activity. The goal of treatment is to heal and rehabilitate the injury so patients can return to their favorite activities quickly, whether it’s Little League, recreational play or a high school, college or professional sport. As with a sports team, there are many physicians who work together to help the patient regain maximum use of the injured limb or joint. “Players” on the team are typically the physician, orthopedic surgeon, rehabilitation specialist, athletic trainer and physical therapist – and the patient him/herself. Common injuries treated include: ACL Tears Compartment Syndrome Fractures Heat Exhaustion Muscle Contusions (Bruise) Muscle Cramps Shin Splints Sprains & Strains Stress Fractures Torn Tendons & Ligaments

THE HISTORY OF ADULT STEM CELL TREATMENT Adult stem cells were discovered over 40 years ago when researchers found that cells derived from bone marrow had the ability to form various tissues. Adult stem cells are early stage cells and under the right conditions, are capable of developing into other types of cells with the potential to regenerate damaged tissue. WHAT IS ADULT STEM CELL THERAPY? Scientists and doctors have made tremendous advances to make tissue regeneration a reality in treating many diseases. Through regenerative medicine, a person can take advantage of their body’s ability to heal itself by using the healthy adult stem cells that can be found throughout the body. Laboratory and clinical research has shown that it is possible to use adult stem cells to restore lost, damaged or aging cells and effectively regenerate tissue in the body. Regenerative therapies are showing promise in the treatment of orthopedic pain. HOW ARE ADULT STEM CELLS UTILIZED? Adult stem cells are being used to treat many types of chronic pain and degeneration. Currently doctors are treating shoulder, knee, hip, and spine degeneration, in addition to soft tissue (muscle, tendon, ligament) and other bone related injuries. WHERE ARE STEM CELLS FOUND IN ADULTS? In adults, stem cells are present within variety of tissues and organs, the most common sources being bone marrow and fat (or adipose) tissue. HOW ARE ADULT STEM CELLS OBTAINED AND PREPARED? One of the richest sources of adult stem cells is bone marrow, and the hip (pelvis) is one of the best and most convenient locations for obtaining bone marrow. In the harvesting procedure, the doctor typically removes (or aspirates) from the pelvis. A trained nurse or technician then uses specifically designed equipment to concentrate the adult stem cells in the bone marrow and provides the cells back to the physician for implantation at the site of injury. WILL MY BODY REJECT THE ADULT STEM CELLS? No, since they are cells collected from your own tissue, there is little threat of rejection. WILL MY INSURANCE COVER THIS PROCEDURE? While adult stem cells have been used for decades to treat a variety of diseases, their application in the treatment of pain is relatively new. Because of this, insurance companies do not currently cover the therapy. HOW MUCH DOES IT COST? The cost of a stem cell treatment varies based on the procedure performed. Our office staff can assist you with payment options and any other questions you may have. Jean Zellweger of Santa Barbara “… the MRI showed that my shoulder had degerated to the point that a complete joint replacement was necessary.” “Dr. Scheinberg gave me another option, a stem cell injection.” “Stem cell injection as a choice to repair my shoulder made sense to me as I am a firm believer in the healthy body’s ability to heal itself.” “I was pain immediately pain free with moderate arm and shoulder mobility.” “I encourage anyone living with pain to make an appointment with Dr. Scheinberg.”

Arthroscopy is a minimally invasive procedure that allows doctors to diagnose and sometimes treat joint injuries and diseases through small incisions in the skin. It is often performed to confirm a diagnosis made after a physical examination and other imaging tests such as MRI, CT scan or X-rays. During an arthroscopic procedure, a thin fiberoptic light, magnifying lens and tiny television camera are inserted into the problem area, allowing the doctor to examine the joint in great detail. With some patients, it is then possible to treat the problem using this approach or with a combination of arthroscopic and “open” surgery. Sports injuries are often repairable with arthroscopy. Tendon tears in the knee are frequently repaired in this way. Other potentially treatable injuries include torn cartilage or ligaments, inflamed joint lining, carpal tunnel syndrome, rotator cuff tears, and loose bone or cartilage. Because it is minimally invasive, arthroscopy offers many benefits to the patient over traditional surgery. No cutting of muscles or tendons Less bleeding during surgery Less scarring Smaller incisions Faster recovery and return to regular activities Faster and more comfortable rehabilitation

WHY WOULD SOMEONE NEED HAND SURGERY? Hand surgery is a specialized type of procedure that may be performed to correct a wide range of diseases, injuries and defects that may cause symptoms and/or affect the appearance of the hand. Hand surgery can be performed for both medical and cosmetic purposes. Your hand surgery procedure will be customized in order to repair your individual condition and leave your hands looking and feeling their best. Because of their frequent use, the hands are a common location for injuries and degenerative disorders such as arthritis. Many people are born with birth defects of the hand as well. Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from cysts, nerve conditions such as carpal tunnel syndrome, arthritis, birth defects and other problems. Hand surgery may also be performed to re-attach or reconstruct severed fingers after trauma. Effective hand surgery requires the skill and precision of an experienced surgeon, in order to successfully treat the condition and restore full function to the hand. WHO IS A CANDIDATE FOR HAND SURGERY? Hand surgery can be performed on patients of any age to correct conditions and deformities within the hands. The ideal candidates for hand surgery include patients who: Do not smoke Do not have any other serious medical conditions Have made the decision for surgery on their own Have realistic expectations for their surgery HAND SURGERY PROCEDURE Hand surgery is usually performed under general anesthesia or local anesthesia with sedation, on an outpatient basis. The surgeon will make an incision to access the targeted area. Many hand procedures can be performed laparoscopically, allowing patients to benefit from smaller incisions, less bleeding and shorter recovery times. WHAT ARE THE DIFFERENT HAND SURGERIES? The actual procedure will vary depending on the type and severity of each patient’s individual condition, but may include: Carpal tunnel surgery – tissue that is causing pressure on the nerve is removed to relieve pressure. Rheumatoid arthritis surgery – damaged tissue is removed from the joint, tendons and ligaments are repositioned, or the entire joint is replaced with a prosthetic. Dupuytren’s contracture surgery – thickened, scar-like tissue is separated to improve range of motion and prevent nerve damage. Grafting – transfers bones, nerves or other tissue from healthy areas of the body to the damaged area, commonly performed after trauma.

WHAT IS ARTHROSCOPIC SURGERY? Arthroscopy is a minimally invasive procedure that allows doctors to examine tissues inside the knee. During an arthroscopic procedure, a device known as an arthroscope is inserted into a small incision in the knee. Through this tube, a thin fiberoptic light, magnifying lens and tiny video camera are inserted, allowing the doctor to examine the joint in great detail. Arthroscopy may be a diagnostic procedure following a physical examination and imaging tests such as MRI or CT scans or X-rays. It may also be used as a method of treatment to repair small injuries in the knee. WHAT CONDITIONS CAN KNEE ARTHROSCOPY TREAT? Relatively minor knee damage is frequently treated using arthroscopic techniques. Most knee damage results from sports injuries or osteoarthritis. During an arthroscopic procedure, the surgeon may be able to treat: Loose bone or cartilage Meniscal tears Torn ligaments Synovitis (swelling of the joint lining) Misalignment of the patella (knee cap) Inflamed tissue In patients with osteoarthritis of the knee, arthroscopy is also used in the removal of dead tissue, a process known as debridement. WHAT ARE THE BENEFITS OF KNEE ARTHROSCOPY? Because it is minimally invasive, arthroscopy offers the patient many advantages over traditional, more invasive, surgery. These include: No cutting of muscles or tendons Smaller incisions Less bleeding during surgery Less scarring Shorter recovery time Shorter and more comfortable rehabilitation CANDIDATES FOR KNEE ARTHROSCOPY Knee arthroscopy is quickly becoming the ideal procedure for many conditions affecting the knee. Its minimally invasive advantages allow patients to receive fast and simple pain relief, increased range of motion and restored function, while avoiding or delaying the need for joint replacement surgery. Despite its many advantages, arthroscopy is not appropriate for every patient. Some patients, especially those with knee problems that are in difficult-to-see areas, may benefit more from conventional surgery. THE KNEE ARTHROSCOPY PROCEDURE Knee arthroscopy is performed on an outpatient basis under local or general anesthesia, depending on the type and severity of the condition, as well as the patient’s personal preference. During the procedure, the surgeon inserts the arthroscope into the knee through a tiny incision. This instrument is used to identify any damage or abnormalities within the knee, or to confirm the diagnosis of a previous imaging exam. If damaged areas are detected, they can be repaired during the same procedure by inserting surgical instruments into additional small incisions. Patient Testimonial: “If you want the best then look no further. The medical skills, surgical ability and integrity of this doctor are of the highest order. My wife and I have been patients of his for many years we are more than satisfied.” RECOVERY FROM KNEE SURGERY After a knee arthroscopy, patients often experience swelling and pain for several days. These symptoms can be controlled by the usual home remedies: Knee pain treatment and Orthopedic Surgeryresting and elevating the leg, applying ice and taking over-the-counter painkillers. Patients are encouraged to get up and walk around as soon as possible after the procedure, although crutches or a cane may be needed for some period of time. WHEN CAN I RETURN TO WORK AFTER KNEE ARTHROSCOPY? Most patients can usually return to work within a week, but will need to undergo physical therapy in order to restore full range of motion to the joint. Most patients can resume light physical activities after a few weeks, although full recovery from knee arthroscopy may take 12 weeks or longer. Dr. Scheinberg will walk you through the recovery process to meet your specific needs. WHAT ARE THE RISKS OF KNEE ARTHROSCOPY? While knee arthroscopy is considered safe for most patients, there are certain risks associated with any surgical procedure. These risks include: infection, blood clots, accumulation of blood in the knee, nerve damage or adverse reactions to medications or anesthesia. In the great majority of cases, the knee arthroscopy goes smoothly.

WHAT IS ARTHROSCOPIC SHOULDER SURGERY? The shoulder is a “ball-and-socket” joint made up of the upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle). This joint is the most flexible one in the body and allows for a full range of motion, but also makes the shoulder a common source of injury and instability. Common Shoulder Issues Some of the most common shoulder conditions include: Bursitis Tendonitis Impingement Rotator cuff tear Instability Fractures Osteoarthritis While many of these conditions can be effectively managed through nonsurgical techniques, surgery is often needed to thoroughly correct the condition and allow patients to maintain an active and healthy lifestyle. ROTATOR CUFF REPAIR The rotator cuff is a group of tendons and muscles that support the shoulder joint and allow for complete movement while keeping the ball of the arm bone in the shoulder socket. These tendons and muscles may become torn or otherwise damaged from injury or overuse and can lead to pain, weakness and inflammation. Surgery is often needed to treat this serious condition. How Is Rotator Cuff Surgery Performed? Rotator cuff surgery may be performed laparoscopically or through an open procedure, depending on the type and severity of the condition. Both procedures are performed under general anesthesia and aim to reattach the tendon back to the arm, along with removing any loose fragments from the shoulder area. LABRAL TEAR SURGERY A labrum is a protective cuff of cartilage found in the shoulder that provides stability, cushioning and a full range of motion. A tear in the labrum, known as a labral tear, is caused by injury or overuse and can lead to pain and “catching” of the joint while moving. While many labral tears can be treated by managing pain symptoms and undergoing physical therapy, some cases require surgical treatment. How Is Labral Tear Surgery Performed? Labral repair aims to repair unstable shoulders with staples, anchors or sutures. It is usually performed using arthroscopy, which allows the surgeon to view the tear through a small camera and perform the procedure through tiny incisions. Larger tears may require an open procedure. SHOULDER STABILIZATION The shoulder can often become dislocated or slip partially out of the joint, a condition known as subluxation. This often develops as a result of a traumatic injury that may stretch or tear ligaments in the shoulder, and may cause it to become unstable. Patients with an unstable shoulder often avoid participating in sports or other activities they would otherwise enjoy. How Is Shoulder Stabilization Performed? Shoulder stabilization can be performed through an arthroscopic procedure that may involve reattaching loose or torn ligaments to the joint with the use of special implants called suture anchors. These anchors are used to relocate and tighten injured structures, and then disintegrate over time. Depending on the individual patient’s joint stability, shoulder stabilization surgery can also repair tears of the biceps muscle tendon, a damaged rotator cuff, or tighten the shoulder capsule. ARTHROSCOPY Arthroscopy is a minimally invasive procedure that can be used to treat many shoulder conditions by inserting a fiber-optic device and tiny surgical instruments into small incisions. Patients can benefit from less tissue damage, shorter recovery times and less scarring with arthroscopic techniques. This procedure can also be used for diagnostic purposes after a physical examination and other imaging procedures have been performed. What Is Shoulder Arthroscopy For? Also known as shoulder scope, arthroscopy can be used to treat rotator cuff tears, labral tears, impingement, biceps tendonitis and AC joint arthritis. The type of repair performed depends on each patient’s individual condition, but often involves removing inflamed tissue, reattaching torn tissue or replacing damaged cartilage. The incisions are closed with sutures and usually heal well. TOTAL SHOULDER REPLACEMENT Severe shoulder conditions with persistent symptoms that have not responded well to conservative treatments may benefit from shoulder replacement surgery. Shoulder replacement surgery replaces the damaged joint with an artificial one that allows patients to enjoy painless motion and resume their regular activities. What To Expect During Total Shoulder Replacement During the shoulder replacement procedure, the damaged bone and cartilage are replaced with a metal and plastic implant that helps relieve pain, stiffness and swelling, while improving range of motion and allowing patients to resume their regular activities.

WHAT CAN SPINAL SURGERY TREAT? Spine surgery can relieve pain and correct injury to the nerves in the back when non-invasive methods are ineffective or inappropriate. Surgery may be performed to remove discs; to treat diseases and disorders such as Arnold Chiari-Malformation, syringomyelia and spinal stenosis; and to correct spinal fractures, injuries, cysts, tumors, herniated cords and other painful or harmful conditions. WHAT SPINAL PROCEDURES ARE AVAILABLE? Discectomy – Performed to correct a herniated disc, the most common cause of lower back pain. The soft material in the disc is removed to restore proper shape and relieve pressure on the nerve. Laminectomy and Laminotomy – Removal of the lamina (small bony plate on each vertebra) to relieve pressure on the nerve that causes back pain in patients suffering from stenosis. Spinal Fusion – Bone is grafted onto the spine that grows and heals to provide strength and stabilization following injury or disease. MINIMALLY INVASIVE SPINAL SURGERY Recent advances in medical technology have made possible minimally invasive spinal surgery, in which the entire procedure is performed through small incisions with the aid of an endoscope (a thin instrument with a tiny camera on the tip). Benefits of Minimally Invasive Surgery over Traditional Spinal Surgery Minimally invasive surgery offers a number of benefits over traditional surgery, including less post-operative discomfort, smaller scars and a shorter recovery time. Who is Eligible for Minimally Invasive Spinal Surgery? This type of surgery is not appropriate for all conditions, but may be performed to treat scoliosis and herniated discs and to aid in spinal fusion. Dr. Scheinberg will be sure to evaluate the best procedure for your specific needs. SCHEDULE A SPINAL SURGERY CONSULTATION If you would like to schedule an appointment online with Dr. Richard Scheinberg click here or call 805-682-1394 today!

Sometimes the best way to relieve pain and restore function to a joint is to replace all or part of it with a prosthesis (an artificial joint). Prostheses are intended to restore function to the joint and relieve pain associated with arthritis, other chronic conditions, or traumatic injury. Prostheses are designed to move like a regular joint. They are made of durable plastic and metal parts that fit together snugly but glide smoothly (as opposed to the painful friction associated with the worn cartilage of arthritic joints). The pieces are shaped like the structures they replace – for example, the damaged bones in a ball-and-socket joint of a hip or shoulder are replaced with a metal ball and plastic socket. They are held to the surrounding bone either with a locking mechanism or with a special bone cement. TOTAL JOINT REPLACEMENT RECOVERY The length and difficulty of recovery depend on the location of the joint replaced as well as the patient’s age and overall health. Hip or knee surgery typically requires temporary use of a cane or walker. Some pain and stiffness following surgery is normal. Gradually, the weakened muscles regain strength and flexibility as the patient becomes accustomed to using the joint. The physician will discuss when it is safe to return to any athletic activities. Once in place, prostheses usually perform well for up to a decade or longer. WHICH JOINTS CAN BE REPLACED? The hip and knee are the most frequently replaced joints, although it is possible to treat many others. Procedures include: Shoulder Joint Replacement Elbow Joint Replacement Wrist Joint Replacement (Arthroplasty) Hip Resurfacing Total Hip Replacement (THR) Total Knee Replacement Ankle Joint Replacement

OCCUPATIONAL INJURY ORTHOPEDICS Dr. Scheinberg treats all occupational injuries as the primary treating doctor in orthopedics. He is capable of treating all orthopedic problems without need for referral to different sub specialists, saving time and expense. He has an efficient support staff to file all appropriate forms and paper work on behalf of the injured workers and their attorneys. In addition Dr. Scheinberg is a highly experienced Qualified Medical Examiner for the WCAB as well as frequently functioning in the capacity of Agreed Medical Examiner in orthopedics for all body parts injured.

Dr. Richard Scheinberg is regarded as one of the most credible and respected medical-legal evaluators in the country. His educational background is as follows: undergraduate education-Princeton University, Medical school education-Duke University, surgical internship and residency-Harvard Medical School, Orthopedic residency-Harvard Orthopedic program. He is highly experienced in court testimony for both defense and plaintiff and is instrumental in resolving disputes. He is considered extremely credible without any hint of advocacy bias. He is the only Harvard educated orthopedist on the central coast performing this service. His testimonies have resulted in multiple large settlements. His judgment and integrity are considered to be of the highest order and both plaintiffs and defense rely on his counsel. Please arrange an appointment by calling (805) 682-1394.

Dr. Scheinberg is an agreed medical examiner for the Workers Compensation Appeals Board. He is able to perform these examinations on all orthopedic body parts and provides appropriate imperant ratings.