About Us: About the Practice

Dr. William F. Sima is committed to excellence by pledging to provide the highest quality of orthopaedic care possible. Along with the treatment of immediate or chronic problems, we strive to integrate the doctrine of prevention in all our treatment plans as a way to alleviate possible future difficulties.

We are pleased to have you as a patient. If you have any questions, always feel free to contact our office and our trained staff will assist you in any way possible.


What's New

Outpatient Same Day Total Joint Replacement procedures represent the next trend in arthroplasty surgery. Many surgeries done today as outpatient procedures were once regarded as “inpatient” procedures. These include ACL reconstruction, rotator cuff repair, upper extremity surgery and arthroscopy. Just a decade ago, a cholecystectomy (gallbladder removal) was performed as an inpatient procedure. Improvements in surgical techniques and anesthesia protocols have allowed surgeons to safely perform these operations in a dedicated surgical suite where patients can safely return home the same day as their procedure. Patient selection, medical optimization and perioperative care and planning are essential.

Common patient apprehensions regarding pain control and becoming dependent on others have been addressed and optimized. We have a better understanding of the entire pain pathway and can therefore effectively control pain using a combination of approaches beginning at the level of the tissue all the way up to the central nervous system. Patients are independent the same day of surgery and can demonstrate the ability to transfer from a bed, a chair, and to ascend and descend a flight of stairs. To make all of this possible requires a team of individuals dedicated to the entire care experience including perioperative care, imaging, anesthesia, postoperative management and outpatient therapy providers. For patients who are appropriate candidates and are medically optimized the surgeon efficiently controls the local environment and therefore can directly improve overall patient care and satisfaction in the outpatient setting.

In an observational, case controlled study conducted between 2008 and 2011 there were 119 outpatient total hip replacements performed using the anterior approach. These were compared with inpatient controls n= 78. There was no difference in complications or blood loss. However, there was a total cost reduction of $6,778 in the outpatient group. We are very excited to now offer outpatient anterior total hip replacement surgery, total knee replacement surgery and unicompartmental knee replacement to our select patients.

Aynardi et al., HSS J 2014.
Cross MB, Berger R. Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. Int Orthop. 2014 Feb;38(2):4437.
Gondusky JS, Choi L, Khalaf N, Patel J, Barnett S, Gorab R. Day of surgery discharge after unicompartmental knee arthroplasty: an effective perioperative pathway. J Arthroplasty. 2014 Mar;29(3):5169.
Berger RA, Kusuma SK, Sanders SA, Thill ES, Sporer SM. The feasibility and perioperative complications of outpatient knee arthroplasty, Clin Orthop Relat Res. 2009 Jun;467(6):14439.
Larsen K, Hansen TB, Soballe K, Kehlet H. Patient reported outcome after fasttrack knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2012 Jun;20(6):112835.

Autologous Platelet Rich Plasma (PRP) therapies have become increasingly popular within the field of orthopedics over the past 5 years. PRP is defined as “a volume of plasma that has a platelet count above baseline of whole blood.” PRP contains many growth factors important in tissue healing and regeneration. Current applications supported by recent literature show evidence for use of PRP in lateral epicondylitis (tennis elbow), patellar tendonitis, arthritis and muscle injuries.

Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial »

The effects of repeated intra-articular PRP injections on clinical outcomes of early osteoarthritis of the knee »

Hsu et al. “Plateletrich Plasma in Orthopaedic Applications: Evidencebased Recommendations for Treatment”, JAAOS December 2013

Mesenchymal Stem Cells (MSCs) are multipotent cells found in the bone marrow that have the ability to differentiate into bone, cartilage, muscle and other mesenchymal tissue. MSCs are antiinflammatory, immunomodulatory and enhance the formation of organized tissue. These cells are often isolated from the superior iliac crest, but alternative donor sites including the femur and tibia can also be used. Potential areas of use include bone healing, tendinopathy, cartilage regeneration,, arthritis, ligament and tendon repair and muscle regeneration.

Tuan RS, Chen AF, Klatt BA. Cartilage regeneration. J Am Acad Orthop Surg. 2013 May;9(5):30311. Review.PMID: 23591485

Autologous Chondrocyte Implantation (ACI) is a two-step procedure. New cartilage cells are grown and then implanted in the cartilage defect. First, healthy cartilage tissue is removed from a non-weightbearing area of the bone. This step is done as an arthroscopic procedure. The tissue which contains healthy cartilage cells, or chondrocytes, is then sent to the laboratory. The cells are cultured and increase in number over a 3- to 5-week period. An open surgical procedure, or arthrotomy, is then done to implant the newly grown cells. The cartilage defect is prepared. A layer of bone-lining tissue, called periosteum, is sewn over the area. This cover is sealed with fibrin glue. The newly grown cells are then injected into the defect under the periosteal cover. ACI is most useful for younger patients who have single defects larger than 2 cm in diameter. ACI has the advantage of using the patient's own cells, so there is no danger of a patient rejecting the tissue. It does have the disadvantage of being a two-stage procedure that requires an open incision. It also takes several weeks to complete.

Learn more about Autologous Chondrocyte Implantation »

The Osteoarticular Transfer System commonly known as OATS, replaces damaged cartilage in the knee with healthy cartilage from another area of the joint, relieving pain and restoring movement and function to the joint. A mosaicplasty is the name for a general procedure that treats severe cartilage damage, and the OATS procedure is one type of mosaicplasty. Although cartilage is essential to smooth, painless movement of the joints, some areas have a more critical need for the support and cushioning provided by the cartilage. During the OATS procedure, small plugs of healthy cartilage are removed from areas of the joint that are not in critical need, and transferred to the area of damaged cartilage. The OATS procedure is ideal for patients with small areas of cartilage damage that can be easily repaired with a graft. Widespread cartilage damage cannot usually be treated with this procedure, since there may be insufficient amounts of healthy cartilage available. After the OATS procedure, patients will need to undergo a lengthy physical therapy program in order to restore range of motion and relieve pain and swelling on the joint. Most patients will be on crutches for 6 to 12 weeks after surgery before they can successfully bear weight on the joint again. Long-term follow-up care will be required in order to maintain the results of this procedure.

Learn more about Osteoarticular Transfer System »

The Anterior Approach to hip replacement surgery allows the surgeon to reach the hip joint from the front of the hip as opposed to the lateral (side) or the posterior (back) approach. This way, the hip can be replaced without detachment of muscle from the pelvis or femur during surgery.

Learn more about Anterior Hip Replacement »
View Anterior Hip Replacement Videos »
Visit Newhipnews.com: Dedicated to Anterior Hip Replacement »

Subchondroplasty (SCP) is a minimally invasive treatment for defects in bone called bone marrow lesions. Bone marrow lesions represent the healing response to areas of insufficiency and micro fractures known to cause joint pain and accelerate joint damage. These lesions are often found within the knee joints. Bone marrow lesions can be diagnosed using magnetic resonance imaging (MRI). SCP treats bone marrow lesions in the knee joint by filling in the defects with an absorbable material. This material is then eventually resorbed and replaced with healthy bone. This procedure can be performed in 30-60 minutes in an out patient surgery center and patients can return home the same day of their surgery.

Learn more about Subchondroplasty »

Unicompartmental knee replacement or partial knee replacement is a surgical procedure where only the damaged portion of the knee is replaced. There are three compartments of the knee. Depending on if your arthritis is confined to a single compartment of your knee will dictate whether you may be a good candidate. Advantages of the unicompartmental knee replacement are quicker recovery, less pain after surgery and less blood loss. In some cases, a unicompartmental knee replacement can be performed in an outpatient surgical suite and patients can return home the same day of their surgery.

Learn more about Unicompartmental Knee Replacement »

SpeedBridge technique is a knotless technique for the repair of a rotator cuff tear that creates a quick and secure construct with no knots that maximizes contact between tendon and bone to enhance healing.

Learn more about SpeedBridge Technique »

 

Patient Portal



Our Specialties Include

Hip Surgery
  • Hip Arthroscopy
  • Total Hip Replacement – Anterior Approach
  • Hip Resurfacing
  • Arthroscopic Labral Repair
  • Arthroscopic Hip Trochanteric Bursectomy
Knee Surgery
  • Arthroscopic Knee Surgery
  • Meniscal Surgery
  • ACL Reconstruction
  • Knee Ligament Reconstruction
  • Cartilage Transplantation
  • Partial Knee Replacement
  • Total Knee Replacement
  • Osteoarticular transplant
Shoulder Surgery
  • Arthroscopic Shoulder Stabilization/Reconstruction
  • Arthroscopic SLAP/Labral Repairs
  • Arthroscopic Rotator Cuff Repair
  • Total Shoulder Replacement
  • A-C Joint Stabilization/ Reconstruction
  • Superior Capsular Reconstruction
  • Reverse Total Shoulder Replacement
Hand and Wrist Surgery
  • Boutonniére Deformity
  • Carpal Tunnel Release
  • DeQuervain's Tendinitis
  • Distal Radius Fracture (Colles' Fracture)
  • Dupuytren's Contracture
  • Trigger Fingers
  • CMC Thumb Joint Arthroplasty
Foot and Ankle Surgery
  • Hallus Valgus deformity (Bunions)
  • Hammertoes
  • Heel Pain
  • Ankle Fractures
  • Ankle Fusion
  • Ankle Replacement
  • Charcot Foot Corrective Reconstruction
Sports Medicine
  • Meniscus Tear
  • ACL Reconstruction
  • Treatment of Shoulder Dislocation/Instability
  • Treatment of Rotator Cuff Disorders
  • Common Sporting and Overuse Injuries
Work Compensation Injury