Cedars-Sinai Kerlan-Jobe Institute Provides World-Class Joint Care for All Athletes and Active Lifestyles
Feb 19, 2021 Cedars-Sinai Staff
No matter the sport or level of play, an athlete’s primary tool is their body. To support peak performance—whether that means carrying a young pitcher through their baseball game, helping a new runner complete their first 5K or preparing a professional football player for the Super Bowl—that body has to be in good working order.
The Joint Preservation Program at the Cedars-Sinai Kerlan-Jobe Institute is here to help when joint pain or problems restrict an active lifestyle. The program was established to help patients maintain their desired level of activity without near-term surgical intervention, when possible. The expert team, which includes primary care sports medicine physicians Kenton Fibel, MD, Joshua Scott, MD, and Casey Batten, MD, specializes in performing different types of nonoperative and minimally invasive procedures, resulting in longer-lasting joints.
“Sometimes surgery is needed right away,” says Dr. Fibel, a nonoperative sports medicine physician and the medical director for the Anaheim Ducks. “But in many cases, there are a number of options before you need surgery. That’s why our group of nonoperative physicians came together. We want to create unique care plans that reflect our patients’ medical and activity goals.”
Cedars-Sinai Kerlan-Jobe Institute saves the game
The Cedars-Sinai Kerlan-Jobe Institute has a long history of providing cutting-edge medical care to elite athletes to keep them in the game and playing at their best. The physicians at the institute treat some of the nation’s finest athletes and teams. They are the official team doctors for the Los Angeles Rams and Los Angeles Clippers as well as doctors for the Angels, Ducks and Galaxy.
The Cedars-Sinai Kerlan-Jobe Institute was built on the shoulders of Robert Kerlan, MD, and Frank Jobe, MD. Dr. Jobe is best known for performing a career-saving ulnar collateral ligament (UCL) reconstruction surgery—the first of its kind—on famed Major League Baseball pitcher Tommy John. Since that first surgery, the procedure has become so common that nearly one-third of all major league pitchers have undergone UCL reconstruction, and it is commonly referred to as “Tommy John surgery.”
From that first groundbreaking surgery to today, the Cedars-Sinai Kerlan-Jobe Institute has been a proud medical provider to athletes of all ages and aspirations, utilizing new techniques and research to provide innovative surgeries and therapies, access to important clinical research and world-class care.
Joint preservation for all active lifestyles
Though the Cedars-Sinai Kerlan-Jobe Institute built its name through the treatment of elite athletes, the sports medicine care the team provides to all athletes—the 50-year-old businessowner training for a marathon after an injury, the stay-at-home dad who plays ball with his kids or the aspiring high school athlete—is no less exceptional.
“Our program focuses on joint preservation—avoiding or postponing joint replacement surgery for those patients who might not be ready for or in need of that solution just yet,” says Dr. Scott, a primary care sports medicine physician and team physician for the Los Angeles Galaxy. “This could be a younger athlete dealing with hip impingement or an older patient with arthritis trying to avoid further degeneration. The older population is becoming much more active than we’ve seen before—playing sports and running regularly—and we want to keep them doing what they want to do.”
One patient, a veteran and recreational skier, Scott Reathaford, sought treatment with Dr. Scott after retiring from active military duty. Years of intense training and physical challenges during his service caused irreparable damage to the cartilage in his knees: osteoarthritis of the knees and other, previously undiagnosed tears and damage were painful and limiting.
Reathaford describes the crepitus and popping in his knees when he ascends a staircase with a tongue-in-cheek reference to the Rice Krispies trio: “Snap, Crackle, Pop.” He has patellofemoral osteoarthritis, and after months of physical therapy didn’t resolve his pain, Reathaford moved to regular injections of hyaluronic acid—viscosupplementation or “gel” injections—at Dr. Scott’s recommendation.
“When I first met Dr. Scott, he asked, ‘What do you love to do? What are your hobbies?’” says Reathaford. “That was a big part of our plan—I’m a big skier, and we timed the injections around ski season.”
An intense love of downhill skiing and a young daughter at home, who counted on him for roughhousing and play, meant Reathaford was initially reluctant to pursue a surgical solution. “You hear nightmares about knee surgery,” he explained. “My daughter loves to ski, too, and it was important that I could keep up with her. I wasn’t ready to take that risk. Now she’s 15, a competitive gymnast and strong all-around athlete, and I’ve been able to keep up with her every step of the way.”
Dr. Scott and the multidisciplinary team at the Cedars-Sinai Kerlan-Jobe Institute don’t just provide care—they are partners in care—and they worked with Reathaford to identify his needs and priorities for improving his pain, functionality and overall quality of life while educating him along the way.
“I’ve learned so much about the knee structure,” says Reathaford. “After seeing Dr. Scott and the physical therapists, I know what stretches will help relieve pain. They’ve given me the tools to manage my own care. It’s a whole team approach, and I’m part of that team.”
Because of the team at the Cedars-Sinai Kerlan-Jobe Institute and the close, trusting relationship built over Reathaford’s course of care, if Dr. Scott recommends that it’s finally time for surgery, Reathaford feels he’ll be ready.
“Dr. Scott and the Cedars-Sinai Kerlan-Jobe Institute gave me almost 10 extra years on these knees. Ten years of running and playing with my daughter. Ten years of great skiing. That’s no small thing.”
"Whatever the medical intervention required, the first step in providing world-class care is building trust. As more patients express a desire to delay an intrusive intervention like surgery, physicians at the Cedars-Sinai Kerlan-Jobe Institute continue to develop minimally invasive solutions."
Building trust to improve medical outcomes
“We coordinate everything—from physical therapy to biologic injections to weight loss and general counseling,” says Dr. Fibel. “Our program includes a variety of specialists committed to finding the best solution for each individual patient, and anything we recommend will be firmly rooted in evidence-based practices.”
The long-term relationship and trust established between patient and physician within this program provides ample opportunity to define success over time and adjust the plan of care. If a patient has exhausted all nonoperative treatments and is in need of surgery, surgeons like John Tiberi, MD, are ready to step in. They work closely alongside their nonoperative colleagues to help determine the best course of care for each patient.
“Success looks different for each patient and depends on their age, goals and other personal factors,” explains Dr. Tiberi. “Nonoperative treatments may help some patients avoid surgery altogether and can help others who will eventually need surgical intervention pursue it on their own terms.”