LAURA N. SCIARONI MD

Fellow of the American Academy of Orthopedic Surgery
Member of the San Francisco Multispecialty Medical Group,
Part of the IPM Medical Group family
Board Certified, Fellowship Trained in Sports Medicine

Cutting Edge Technologies

I’m not an early adopter of new technologies, though I am interested in them. I like to see a lot of evidence before I offer a new treatment to my patients.  I get asked a lot about these in the office, so here is some information.   Orthobiologics – treatments using biological components that come…

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Controversies in Treatment of Achilles Tendon Ruptures

Achilles tendon ruptures are very common sports injuries.   Many years ago, these were treated without surgery, but muscular weakness and a high risk of re-rupture were common problems.  Over the past 10-15 years, the majority of orthopedists have advocated repair.  Repair clearly decreases the risk of re-rupture, but muscular weakness remains an issue, and there are…

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Operation Rainbow

Last week I was priveleged to join Operation Rainbow on an orthopedic mission to Guatemala.  I’ve been familiar with their work for a number of years, as some of my San Francisco colleagues have been on trips with them.  This inspiring group does great work taking care of patients and educating doctors in developing countries.  Last week…

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There’s No Place Like Home

As this recent article from the New York Times points out, the rehab facility (or hospital) is not the best place to recover from joint replacement surgery.  You want to get out of the hospital as soon as you are stable and get home where (1) you won’t be exposed to a lot of sick people and (2)…

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Relieving Post Surgical Pain Without Narcotics?

Orthopedic surgery is painful.  There’s just no getting around the basic fact.  A lot of my patients, when they learn they need surgery, are more concerned about the pain, than the details of the actual surgery.  And almost no one really wants to be on narcotics.  Fortunately with multi-modal pain management (using smaller amounts of several…

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Shoulder Dislocation and Re-Dislocation

Anterior shoulder dislocation is a common injury, and one that I see frequently in athletes of all ages.  Risks of repeat dislocation depends on many factors, including particularly the injured person’s age, whether the dislocation caused any bony defects, and the size of those defects.  Decision making regarding surgery/no surgery can be difficult in some…

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Barefoot Running

Some years after the surge in popularity of barefoot running or running in minimalist shoes, there is enough data for an orthopaedic review article.  The verdict?  A decrease in anterior knee pain (runner’s knee) and a decrease in chronic exertional compartment syndrome.  But, an increase in risk of repetitive stress injuries to the foot and…

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NSAIDs and Tendinitis

The New York Times published an article in the past couple of days about NSAIDs and their use to treat tendinitis.  The basic point is, tendinitis really isn’t an “-itis.”  That is, it is not an inflammatory condition but rather one of tissue breakdown and as such, NSAIDs treat only symptoms and are not curative.…

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EHR

Electronic Health Records, otherwise known as electronic medical records, have been around for over 20 years now in various forms.  Despite their longevity and growth in implementation in recent years, they have not improved.  They have increased the cost of providing medical care without improving efficiency or, in many instances, patient safety. EHR is a…

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Save My Knees

Many times I have patients come to me with knee pain, and want advice on how to “save” them so they don’t wear out.  Their usual assumption is that minimizing the use of their joints will “save” them or extend their useful life.  While that is probably true of your car tires, it is not true of…

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