This continues to be the primary question I hear from my patients. Fortunately, the answer is "Yes." For the past two decades at The Stone Clinic and the Stone Research Foundation, we have dedicated ourselves to answering this question through the advancement of orthopaedic science, sports training, and rehabilitation. With the publication of our 2 – 12 year study on the replacement of  the meniscus combined with articular cartilage repair, we can now confidently counsel both our young and older patients that the new  meniscus can act as the shock absorber for the knee when the articular cartilage is simultaneously treated. Patients who are candidates for joint replacement will be happy to learn that the bionic replacments have improved substantially, permitting many people with severe athritis to return to sports. During 2010, our clinic expanded both its biologic and bionic programs. This year-end note highlights the top stories and will hopefully help you take advantage of the advances in orthopaedic science, sports training, and rehabilitation.

 

and The Stone Clinic Team
 

	ROBOTIC SURGERY AND THE COON JOINT INSTITUTE AT THE STONE CLINIC When “biologic” joint replacement is not an option, patients have a new option for “bionic” joint replacement. The artificial joint world has evolved away from depending solely on a surgeon’s skill. Now, by combining the surgeon’s skill with the computerized accuracy of a MAKO robot in the operating room, the result is exceptional implant accuracy, smaller incisions, less pain, and faster recovery. To complement our surgical and rehabilitation skills, The Stone Clinic facilitated the opening of the San Francisco office of the St. Helena Coon Joint Replacement Institute. Their team, led by Thomas Coon, MD, performs approximately 1,000 robot-assisted joint replacements each year with outstanding results.
	CARTILAGE REPLACEMENT STUDY SUCCESS The Journal of Bone and Joint Surgery (British edition) published the results of our 2 – 12 year outcome study on combined meniscus allograft transplantation and articular cartilage repair. This landmark study followed the largest-to-date population of highly arthritic patients with exceptionally promising results. Statistical analysis estimates that patients, even those with arthritic knees, can expect an average of 9.9 years of pain relief by undergoing a biologic joint replacement of the meniscus cartilage and the arthritic articular cartilage.
	MEET OUR NEW RESEARCH AND NURSING TEAM MEMBERS During 2010, Jonathan Pelsis, MHS advanced to the position of Senior Research Coordinator at the Stone Research Foundation. Jonathan has been a staff researcher at the Foundation since 2008. He oversees all research programs and coordinates the Foundation’s educational programs, annual meetings, and communication efforts. Jonathan holds a Masters of Health Science degree in Bioinformatics and Biostatistics. We also wecome Natalie Heckaman, LVN, as clinical nurse of The Stone Clinic. Natalie is committed to direct patient care as our office nurse and is responsible for ensuring that our patients are well cared for from their initial visit all the way through recovery.
	CROSSFIT AND THE ELLIPTIGO CROSS TRAINING Stone Clinic physical therapist David Birkey, DPT, received his CrossFit Level One certification this year in an effort to continue our philosophy of treating patients as athletes in training rather than patients in rehab. By combining daily rehab with daily fitness training, patients are returning to activities fitter, faster, and stronger than they have in years.  New rehab tools include the ElliptiGo, a rolling elliptical training device that simulates running. The device permits the smoothness people have come to expect from an elliptical workout with running motion, an outdoor experience, and the addictive endorphins gained from both running and cycling. The exercise is highly gluteus muscle dominant!
	NEW SINGLE INJECTION JOINT LUBRICATION The use of joint lubrication and PRP/growth factor injections continues to increase. While both treatments provide patients with relief from joint stiffness, the injections differ in their mechanism of action. In knees with osteoarthritis, the synovial (joint) fluid can break down and not provide the cushioning the joint requires. Joint lubrication injections supplement your knee fluid to relieve pain and improve the knee joint’s natural shock absorbing abilities. The treatment includes either a single injection of HA called Synvisc-One®, or a series of 3-5 injections in the knee, administered at weekly intervals. PRP/growth factor injections are designed to stimulate repair of the damaged tissues inside the knee. The Stone Research Foundation designed a definitive tissue repair study of growth factors which they will conduct during the coming year.
	POTENTIAL BENEFITS OF BAREFOOT RUNNING Rehabilitation is more than just recovery from injury or surgery. Exercise technique plays an important role in sports performance and longevity. New research published this year highlights the importance of running technique: landing mid-foot is dramatically better than landing on the heel. Consequently, all the years of running shoe development with large heel shock absorbers is being re-evaluated and the products are being redesigned. Many of our patients are benefiting from these technique improvements and exercise instruction. We continue to believe it is best to exercise daily. An intense half an hour a day is better than an hour four times a week. The endorphins from exercise and the pain felt at the edges of conditioning are what must be pushed through to make serious gains.
	TED CONFERENCE AND THE BIO-FUTURE OF JOINT REPLACEMENT In January, 2010, the Technology, Entertainment and Design (TED) conference invited Dr. Stone to do a presentation on The Bio-Future of Joint Replacement at their annual meeting. The conference, which is attended by many of the world’s leading thinkers, was an opportunity to share the work of The Stone Clinic and the advanced research reported by the Stone Research Foundation.