Treatment Applications

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SPORTS
MEDICINE

Get back on the field

We specialize on sports-related injuries. We are proud to help everyone from child athletes to professional athletes.

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ARTHRITIS
TREATMENT

Enjoy Life

Arthritis makes the simple things in life such as walking, very painful and difficult. We can provide relief to people of all ages.

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PAIN
MANAGEMENT

Hyaluronic Acid Injections

We have had tremendous success relieving pain with these injections. Come see if it is right for you.

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WORKPLACE
INJURIES

Experienced Help

Our extensive experience not only allows us to help medically, but also help you navigate the additional paperwork and concerns of workplace injuries.

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SURGICAL
CARE

Take Care!

Pre- and Post-Op care is essential for a full recovery. This includes rehab right in our own facilities.

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Orthopedics and Orthopedic Surgery

Our Orthopedic Clinic specializes in orthopedic surgery. As orthopedic surgeons, our physicians are medical doctors with extensive experience in the diagnosis and treatment of injuries of the musculoskeletal system. Our training includes experience in dealing with the diagnosis and treatment of diseases and injuries of the bones, muscles, tendons, nerves and ligaments in adults and children. In addition, we are also trained in various orthopedic subspecialties including treatment of the hand, foot, children’s orthopedic disorders, sports medicine and arthroscopic surgery, arthritis and total joint replacements, orthopedic oncology, scoliosis and spinal surgery and fracture care.

For problems outside our field, we will assist you in finding the appropriate specialist. As a patient, you will have your own treating physician. In the event that your doctor is not available, another one of our physicians or physician’s assistants will be glad to see you so that there is no loss in the continuity of care.

Because continuing post-graduate education is essential in providing the best long term care for our patients, the orthopedists in our clinic may be out for several weeks each year for the purpose of teaching and learning advances in orthopedics. In a doctor’s absence, another orthopedic physician in our clinic will be available for your emergency care questions.

In addition to our highly trained physicians, our office is staffed with devoted personnel who provide the best of care during all phases of your treatment.

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Hyaluronic Acid Injections

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For Pain Management

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For Arthritis Treatment

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The Cartilage Restoration Center

The Cartilage Restoration Center is headed by Keith S. Feder, MD and Carol Frey, MD. These two orthopedic surgeons have further developed an advanced treatment center for post traumatic osteoarthritis chondral injuries and osteochondritis dissicans of the knee, ankle (talus), shoulder, elbow and hip. Dr. Feder and Dr. Frey have extensive experience in revision surgery. Procedures performed include:  micro fractureOATS (Osteochondral Autograft Transfer), ACI(Autologous Chondrocyte Implantation), osteochondral allograft implantation, and osteotomies of the femur, tibia, foot and ankle.

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PRP – Platelet Rich Plasma and Stem Cell Therapy

Platelet Rich Plasma Therapy

Platelet Rich Plasma (PRP) is an injection of your own blood into an area of chronic inflammation, to stimulate healing.  These platelets release substances known as “growth factors” that promote tissue healing.

Platelet Rich Plasma (PRP) treatment should be considered if a patient has a chronic tendon injury in which conservative treatment such as anti-inflammatory medication, physical therapy and bracing have not provided relief.

An initial evaluation with the physician will determine if Platelet Rich Plasma (PRP) therapy is a viable treatment option for you.

How the PRP process works:

  1. Outpatient procedure, which is done in our office, and will take approximately 1 hour.
  2. Do not take Anti-Inflammatory medication (1 week prior to PRP injection).
  3. Blood is drawn from the patient, then it is spun in a centrifuge. The blood samples are now several layers.  The platelet rich plasma layer contains the healing factors, which is removed.
  4. The PRP is now injected into your area of injury or inflammation.
  5. The procedure may cause some localized soreness and discomfort.
  6. Ice may be applied for pain and inflammation initially following injection.
  7. Elevate injury site as needed.

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How is PRP Paid: 

Contact the office to discuss cost/payment.  Pre-screening of Insurance will be required prior to PRP therapy.

Returning to Regular Physical Activity: 

PRP treatment is designed to promote long term healing of the injury and is not a “quick fix”.   PRP requires time and rehabilitation time following the injection for the injury to heal.  You will schedule follow up visits with your physician following the PRP injection to determine when you are able to begin physical therapy and progress to regular physical activity.

Possible Side Effects:

Although uncommon, risks can include those signs/symptoms associated with an injection including: pain, infection, no improvement or worsening of symptoms, blood clot, nerve injury, skin discoloration, calcification, scarring, loss of fat to the affected area, and allergic reaction.

Stem Cell Therapy

For more information on Stem Cell Therapy, visit the American Academy of Orthopaedic Surgeries website.

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Alpha 2 Macroglobulin

Alpha 2 Macroglobulin is used to treat Cartilage Damage and Osteoarthritis (OA).

What causes Cartilage Damage and Osteoarthritis (OA)?

The 3 Protein Classes include Cytokines, Matrix Metalloproteinases (MMP’s), and ADAMTS Degradation Proteases. Cytokines work by degrading the cartilage in your joint and the MMP’s and ADAMTS degradation proteases damage your joint by breaking down the cartilage cells.


Developing the Cure for Osteoarthritis (OA)

Breakthrough scientific research has discovered the secret to stopping all of these cartilage damaging proteins, a-2-Macroglobulin (A2M). With this significant advancement in the understanding of Osteoarthritis (OA), scientific evidence points to A2M to be the key to stopping OA at the molecular level.


What is Alpha-2-Macroglobulin (A2M)?

A2M is a Broad Spectrum Multi-Purpose Protease Inhibitor with a “bait and trap” mechanism. This “bait and trap” mechanism captures and inactivates the bad chemicals damaging your joints and causing pain. Once these bad chemicals are trapped by the A2M, the body eliminates them through natural mechanisms.


Where does Alpha-2-Macroglobulin (A2M) come from?

A2M is found in high concentrations in your blood. The A2M found naturally in your blood inhibits all three proteins that break down your cartilage, causing Osteoarthritis (OA). The protective characteristics of A2M designate this vital protein as the human body’s own defense against Osteoarthritis (OA). Similar to your body increasing white blood cells in response to infection, A2M is unregulated in response to a cartilage injury. A significant research study out of Brown University, in collaboration with the National Institute of Health, demonstrated that although concentration of intra-articular A2M is insufficient for joint protection, a supplemental intra-articular injection of A2M provides chondral protection in post-traumatic OA by stopping the progression of Osteoarthritis (OA).


Alpha-2-macroglobulin (A2M) Therapeutic Potential

Based on extensive scientific research, concentrated Alpha-2-Macroglobulin (A2M) haas been identified as the primary therapeutic agent for Osteoarthritis (OA). the results of a milestone of research study suggest that therapeutic injection of concentrated A2M supplementation beyond endogenous levels may inhibit protease activity. Additionally, it is noted that early intervention may be critical for preventing or minimizing the development of Post-Traumatic Osteoarthritis (OA).


Shockwave Therapy (Swiss Dolorclast Method)

Carol Frey, M.D. was a lead author on a confirmatory study (“Radial Extracorporeal Shock Wave Therapy Is Safe and Effective in the Treatment of Chronic Recalcitrant Plantar Fasciitis”) published in The American Journal of Sports Medicine determining the effectiveness and safety of extracorporeal shockwave therapy.

What is shockwave?

Extracorporeal shockwave therapy (ESWT) delivers low-energy shockwaves to the tissue of the afflicted area of the body, inducing a microtrauma to the tissue and significantly improving pain, function, and quality of life for patients. This microtrauma triggers a healing response by the body, increasing blood vessel formation and the amount of nutrients to the affected area. ESWT is used to stimulate healing and relieve symptoms and is most commonly a solution for plantar fasciitis. ESWT can be used as a non-invasive solution for:

  • Heel Pain
  • Shoulder Pain
  • Elbow Pain
  • Tennis Elbow
  • Plantar Fasciitis
  • Tendonitis
  • Achilles Tendonitis
  • Tendonosis
  • Lateral Epicondylitis
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Custom Orthotics

We specialize in custom-made semi-rigid sports orthotics.

To order custom orthotics please contact the office at 310-416-9700

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Bone Marrow Concentrate (BMC)

What is Bone Marrow Concentrate (BMC)?

Bone Marrow Concentrate (BMC) Therapy, also known as Bone Marrow Aspirate Concentrate (BMAC) Therapy, is a promising cutting-edge regenerative therapy to help accelerate healing in moderate to severe osteoarthritis and tendon injuries.


How does BMC therapy work?

While similar to Platelet Rich Plasma (PRP) in its ability to harness the body’s ability to heal itself through the aid of growth factors, BMC also utilizes regenerative cells that are contained within a patient’s own bone marrow. The marrow contains a rich reservoir of “pluripotent” stem cells that can be withdrawn from the patient’s hip bone and used for the procedure. Unlike other cells of the body, stem cells are “undifferentiated”, meaning they are able to replicate themselves into various types of tissue.


What is BMC therapy?

BMC therapy is a promising non-surgical regenerative treatment used to treat various orthopedic injuries, including moderate to severe osteoarthritis and tendon injures. BMC is a concentrate of regenerative stem cells obtained from a patient’s own bone marrow. The physician removes a small amount of the patient’s bone marrow and spins it in a centrifuge in order to generate a powerful concentrate that is injected into the injured area. In the past, these types of cells were often very difficult and expensive to obtain from the body. With recent medical advancements, the cells can be easily obtained and the procedure can be done with minimal discomfort by a simple office procedure.


Is removing bone marrow or the injection procedure very painful?

While there is some slight discomfort, most patients tolerate the procedure very well and with minimal pain. The procedure is done under local anesthetic to minimize any discomfort. Post-injection soreness at the injection site is sometimes present because of an inflammatory response caused by BMC therapy. This soreness usually resolves on its own within a few days after the injection. It is important that anti-inflammatory medications such as Ibuprofen, Naproxen and Aspirin be avoided following treatments because these medicines may block the effects of the intended healing response facilitated by the post-injection inflammation. It is acceptable to use pain medication such as Tylenol, and in some cases a prescribed pain reliever which does not have anti-inflammatory properties, to control discomfort as needed.


Why use BMC?

Unlike other cells of the body, bone marrow cells are “undifferentiated”, which means they have the ability to replicate themselves into a variety of tissue types. When injury occurs, the usual number of regenerative cells needed for tissue regeneration is often inadequate. With BMC, the concentrate of regenerative cells provides a more robust healing of the damaged tissue and aids in growth and repair by accelerating the body’s natural healing mechanism. While the full benefits of BMC are still unknown, it has been shown to reduce swelling, relieve pain, and enhance healing of articular cartilage and bone.


What types of conditions are treated with BMC?

Numerous conditions can be considered for treatment with BMC. Based on current research and clinical experience, moderate to severe cases of osteoarthritis and severe tendon injuries show promising results.


What can be treated?

  • Knee Pain – Osteoarthritis, Meniscus Tears (Medial, Lateral), Chondromalacia Patella, Tendon Injuries (Patellar Tendonitis, Quad Tendon), Ligament sprains or tears (MCL, LCL, ACL)
  • Hip Pain – Osteoarthritis, Hip Labrum Tears, SI Joint Dysfunction, Piriformis Syndrome, Greater Trochanteric Bursitis, Iliotibial Band (ITB) Syndrome
  • Shoulder – Osteoarthritis, Rotator Cuff Tendinitis, Tendonopathy, or Partial Tears, Labrum Tear, Bicipital Tendinitis
  • Elbow Pain – Lateral Epicondylitis (Tennis Elbow), Medial Epicondylitis (Golfers Elbow)
  • Wrist/Hand Pain – Osteoarthritis, DeQuervain’s Tenosynovitis
  • Ankle & Foot Pain – Achilles Tendinitis or Partial Tears, Plantar Fasciitis, Ankle sprains/ligament injury
  • Spine – Facet Joint Arthropathy. Sacroiliac (SI) Joint Dysfunction

What is the difference between PRP (Platelet Rich Plasma) and BMC?

In general, PRP may be more appropriate for mild to moderate osteoarthritis or tendon injuries. BMC may be reserved for more challenging cases such as moderate to severe osteoarthritis or when more potent effects are desired.


How is the treatment performed and administered?

The process is relatively simple. The area of extraction is locally numbed so no pain is felt. Bone marrow is extracted from the back of the patient’s pelvis or hip bone from an area called the posterior iliac crest.

A suctioned syringe attached to a long needle is used to reach the posterior aspect of the hip, during the minimal discomfort is felt due to local anesthetic. The collected sample is transferred through a filter then placed in a centrifuge for spinning. Spinning at a high speed separates the platelets and stem cells from the bone marrow sample. The concentration of stem cells and healing components, collectively known as the bone marrow concentrate, are reintroduced to the injured area under ultrasound guidance.

Once introduced at the site of injury, the platelets release growth factors that tell the regenerative cells what to become, thereby initiating the regenerative response. The entire process takes approximately 2 hours and patients go home the same day.


Is BMC curative or just a temporary band-aide?

No. Unlike cortisone shots which mask symptoms and can damage tissue, BMC targets the root of the problem and attempts to heal the tissue.


How many treatments will I need?

Most patients require only a single BMC treatment depending on the degree of the injury. However, in challenging cases, if a patient experiences significant relief that plateaus, they may consider a second BMC injection months later.


How quickly can I get back to my regular routine?

For the first 2-3 days, swelling and discomfort are typical in the injected area. By the end of the first week, these symptoms usually begin to resolve and physical therapy is started to optimize BMC effects and facilitate recovery. Patients have responded to BMC treatment at varying timeframes.


Are there any contraindications (i.e. exclusion criteria) that would inhibit someone from getting BMC?

Bone marrow derived cancer (such as lymphoma), non-bone marrow derived cancer or metastatic disease (should be checked with your oncologist), and active systemic infection are all contra-indications. Blood thinning medications such as Coumadin must be discontinued and managed appropriately by your cardiologist or primary doctor prior to the procedure.


Is BMC covered by Insurance?

No. While there are currently several publications in peer-reviewed medical journals showing the positive effects of BMC therapy on tendon, soft tissue, and cartilage injuries, BMC is still not covered by insurance companies at this time.


How long does it take BMC to “work”?

Most patients notice some level of improvement by 2-6 weeks following BMC. Increased stability and strength are typically reported along with the decrease in pain. A second level of benefits may be obtained between 6 weeks and 3 months. Patients are encouraged to remain active with a functional rehabilitation program and strengthen surrounding muscles during this period.

Sports Medicine

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Our physicians specialize in orthopedic sports medicine for athletes of all ages and skill levels. They provide customized preventative programs, injury rehabilitation, arthroscopy and reconstructive surgery. Their specialty training guides the treatment of every individual patient, regardless of age, activity level or mechanism of injury. Their goal is the return to optimum recovery and maximum performance for every patient and athlete.

Arthritis Treatment

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Our physicians specialize in orthopedic sports medicine for athletes of all ages and skill levels. They provide customized preventative programs, injury rehabilitation, arthroscopy and reconstructive surgery. Their specialty training guides the treatment of every individual patient, regardless of age, activity level or mechanism of injury. Their goal is the return to optimum recovery and maximum performance for every patient and athlete.

Pain Management

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Our physicians specialize in orthopedic sports medicine for athletes of all ages and skill levels. They provide customized preventative programs, injury rehabilitation, arthroscopy and reconstructive surgery. Their specialty training guides the treatment of every individual patient, regardless of age, activity level or mechanism of injury. Their goal is the return to optimum recovery and maximum performance for every patient and athlete.

Workplace Injuries

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Our physicians specialize in orthopedic sports medicine for athletes of all ages and skill levels. They provide customized preventative programs, injury rehabilitation, arthroscopy and reconstructive surgery. Their specialty training guides the treatment of every individual patient, regardless of age, activity level or mechanism of injury. Their goal is the return to optimum recovery and maximum performance for every patient and athlete.

Surgical Care

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Our physicians specialize in orthopedic sports medicine for athletes of all ages and skill levels. They provide customized preventative programs, injury rehabilitation, arthroscopy and reconstructive surgery. Their specialty training guides the treatment of every individual patient, regardless of age, activity level or mechanism of injury. Their goal is the return to optimum recovery and maximum performance for every patient and athlete.