November 2015

Download the Complete issue as a PDF (10mb)

Download the Complete issue as a PDF (10mb)

Cover Story


Battles of Achilles II: How the debate is informing clinical practice

Four years later, the ongoing discussion of the relative merits of surgical and nonsurgical management of Achilles tendon rupture is starting to affect practice patterns – even in the US.

By Cary Groner

Editor Message


Out on a limb: Hockey gets hip to FAI

Despite evidence of significant lower extremity injury risks associated with ice hockey, even at youth levels, preventing those types of injuries has never been a priority in that sport. But that may be starting to change.

Jordana Bieze Foster, Editor

LER: Pediatrics

Pediatric11-15cvr-smAdding experts to care team

True multidisciplinary care can yield great benefits for patients, but despite all the emphasis that makes the statement almost a cliché, it’s not always what patients receive. I first realized this when I was interviewing the heads of various departments and divisions of a large academic medical center, where for many years I was an editor publishing on the faculty’s clinical work and research.

Continue Reading →

Departments


Surgeon finds himself on other end of scalpel

A meniscal injury gave one practitioner new insight into the patient experience and renewed his belief that healing isn’t just about what happens physically.

By Cary Groner

Equinus: Its surprising role in foot pathologies

Although milder than the spasticity-induced cases of equinus, limited ankle dorsiflexion in the non-neurological pop­ulation is increasingly recognized as a source of excessive strain throughout the foot and a factor in the pathogenesis of many foot conditions.

By Nicholas V. DiMassa and Jeffrey M. Whitaker DPM, FACFAS   

Experts revisit hyperbaric oxygen for diabetic ulcers

Recent analyses cautiously recommend the short-term adjunctive use of hyperbaric oxygen therapy (HBOT) for diabetic foot ulcer healing under certain conditions, but in the absence of high-quality clinical trials, experts continue to debate the controversial therapy’s benefits.

By Hank Black

Quadriceps symmetry after ACL reconstruction

Using muscle function symmetry as an indicator of patient progress after anterior cruciate ligament (ACL) reconstruction can provide insight about potential targets for intervention to improve movement quality, functional performance, and patient outcomes.

By Christopher Kuenze, PhD, ATC; and Adam Kelly, MS, ATC     

Intermittent claudication: next-generation therapy

Given that existing therapies for intermittent claudication are not appropriate for all patients, researchers are working to develop new therapies focused on improving patients’ ability to compensate for a vascular occlusion by expanding collateral artery pathways.

By Steven J. Miller, PhD; A. George Akingba, MD, PhD; and Joseph L. Unthank, PhD 

News

In the Moment: Foot Care

By Katie Bell and Jordana Bieze Foster

Fusion and low vitamin D: Two thirds of patients have deficiency

Vitamin D deficiency is prevalent in patients in the northern US undergoing midfoot, hindfoot, and ankle arthrodesis, even in those without predisposing risk factors, according to a recent study from Vermont that may have implications for lower extremity surgery.

By Katie Bell

Intrinsic exercises may help runners safely switch to minimalist footwear

The development of bone marrow edema after transitioning from traditional running shoes to minimalist footwear is associated with small intrinsic foot muscle size, according to research from Brigham Young University in Provo, UT.

By Jordana Bieze Foster

Half shoe outperforms double rocker for offloading, but also impairs gait

A half shoe offloads the forefoot more effectively than a double-rocker full-outsole shoe with an offloading insole, but the half shoe also is more likely to alter gait, according to research from Bologna, Italy.

By Jordana Bieze Foster

In the Moment: Osteoarthritis

By Lori Roniger and Jordana Bieze Foster

On the move: Gait training improves limited mobility

Gait training is effective for improving limited mobility in patients with knee osteo­arthritis (OA), according to a recent study, but the immediate benefit is not sustained after training has stopped.

By Lori Roniger

Cartilage thickness study suggests role of kinetics changes with OA severity

Although knee adduction moment (KAM) plays a significant role in patients with severe knee osteoarthritis (OA), knee flexion moment (KFM) may be more important early in the disease process, according to research from Stanford University in California.

By Jordana Bieze Foster

Patient-reported function, kinematics predict response to hip strengthening

Patient-reported function and lower extremity kinematics can predict response to a hip strength­ening intervention in patients with knee osteoarthritis (OA), according to research from the University of Calgary in Alberta, Canada.

By Jordana Bieze Foster

Market Mechanics

By Emily Delzell


CMS stays prosthetic coverage draft; AOPA calls the decision a ‘partial win’

The White House announced on November 2 that the Centers for Medicare & Medicaid Services (CMS) will not finalize a controversial draft policy concerning coverage determinations for lower limb prostheses.

Judges weigh murder charge for Pistorius

Five South African judges are considering the fate of Oscar Pistorius after a November 3 hearing in the Supreme Court of 
Appeal in Bloemfontein.

AMP1 team showcases stand-up skills

AMP1, the stand-up amputee basketball team sponsored by Irvine, CA-based Freedom Innovations, showcased its skills in the October “Duel In The Desert” event in Phoenix, AZ. A red AMP1 team played its blue counterpart, with…

Ossur hosts Boston bombing survivors

Boston Marathon bombing survivors Patrick Downes and Jessica Kensky in September visited Össur’s global headquarters in Reykjavik, Iceland, to discuss their experiences as recent amputees and to learn about innovations in prosthetic limbs.

AAOS clarifies guidance for ACL injuries

The Rosemont, IL-based American Academy of Orthopaedic Surgeons (AAOS) in October released a new appropriate use guideline for anterior cruciate ligament (ACL) injury to clarify recommendations from its 2014 ACL injury guidelines.

Kingetics awarded for advanced materials

The American Composite Manufacturing Association and the Society for the Advancement of Material and Process Engineering honored Kingetics for its creativity with application of advanced materials at the Composites and Advanced Materials Expo (CAMX) in October in Dallas, TX.

OHI acquires custom orthotic lab Footbon

Ronkonkoma, NY-based Orthotic Holdings (OHI) in October acquired the custom foot orthotic laboratory Footbo ̄n. Paul Langer, who founded Huntington, NY-based Footbo ̄n in 2009, has joined OHI’s Langer Biomechanics as…

Dates set for World Congress of Podiatry

The International Federation of Podiatrists and the Canadian Podiatric Medical Association in October announced that the 2016 World Congress of Podiatry is scheduled for May 26-28 in Montreal, Canada.

Cadence Kickstart studied for stroke rehab

Seattle, WA-based Cadence Biomedical in October announced a National Institutes of Health-funded research collaboration with the University of Nebraska-Omaha (UNO) to study stroke survivors’ ability to adapt and…

Tamarack wins business award for textiles

Minneapolis-based Minnesota Business Magazine in September awarded Tamarack Habilitation Technologies its Minnesota Manufacturing Award in the New Products: Textiles category.

Products


Arch Rival
 Orthosis

DJO Global offers the new Arch Rival, a prefabricated orthosis designed to treat subtle cavus foot. The Arch Rival promotes natural foot function by improving stability, adding shock absorption, and alleviating pain.

Levy Diabetic Econ Orthoses

Levy & Rappel introduces the new Levy Diabetic Econ I and Econ II foot orthoses. Both of these custom foot orthoses for patients with diabetes are manufactured using plaster casts, foam impressions, or 3D scans of the patient’s foot.

MineralRich
 Concentrate

Maximum Living Quality Supplements now offers its new Maximum Living MineralRich Concentrate. Designed to be added to healthful smoothies, fresh juice, or water, the liquid supplement provides pH balancing…

Sols Flex 
Insoles

Sols introduces Sols Flex, 3D-printed customized foot orthoses now available directly to consumers. Sols Flex insoles follow the contours of each wearer’s foot to achieve a fit that is intended to be perfect for the wearer, for his or her shoes, and…

Terion K2 
Prosthetic Foot

Durable with a 385-lb weight limit and lightweight at just 325 g, the new Terion K2 1C11 from Ottobock is an adjustable, low-profile prosthetic foot with a split-toe design for use by level K2 amputees.

TaloStabil
 Ankle Support

The new Bort Select TaloStabil (#054 700) from Bort-Swiss Orthopedic Supply is an active ankle support. Constructed of anatomical 3D knitted fabric, the ankle support provides class II compression and incorporates two…

Integrated 
Uprights

MultiMotion contracture management Corrective and Free Motion joints from Allard USA are now available with integrated uprights. Choose from a combination of proximal and distal straight uprights or…

JAFO BK 
Freedom Cover

The BK Freedom Cover from JAFO is a lightweight, easy-on, easy-off custom neoprene prosthetic cover that provides a shapeable foam to replicate the calf on below knee amputees. The BK Freedom Cover is available in three heights…

Heel Entry 
Pediatric Shoe

KeepingPace Children’s Orthopedic Footwear now offers its new pediatric heel entry shoe. The new pediatric shoe features triple width and double depth, so it can be worn easily with ankle foot orthoses as well as…

CalluStop 
Cream

CalluStop cream from Dr. Swaim’s Natural Skin Care is infused with keratolytics and essential oils to maximize the moisture content in human skin. Naturally derived urea and lactic acid help soften skin and promote exfoliation while…

SmartPuck 
Internal Vacuum

The SmartPuck from 5280 Prosthetics is an internal vacuum system that represents a new generation of smart socket technology. The entire unit is designed to fit inside the prosthetic socket, eliminating vacuum leaks from…

TheraSport
 Athletic Socks

Therafirm, a brand of Knit-Rite, has launched the TheraSport line of gradient compression athletic performance and recovery socks. TheraSport athletic socks are engineered to improve circulation and provide more energy for…

Airshift OA 
Knee Brace

The new AirShift OA knee brace from Medical Specialties uses an air bladder system to comfortably unload the opposite compartment of the knee. The AirShift is primarily used to treat unicompartmental knee osteo­arthritis, but…

Endevr StrengthTape

StrengthTape, a new therapeutic elastic tape from Endevr, is designed to be an ideal blend of stretch and stick that supports lower extremity muscles and joints without limiting movement or falling off.

OPTP 
Pro-Roller Soft

OPTP has introduced a new foam roller to its signature line of Pro-Roller products. The 18″ x 6″ Pro-Roller Soft is the first of its kind in the Pro-Roller family. The 18″ length and compact size make it easy to carry or…

Triple Action
 Ankle Joint

Becker Orthopedic is proud to introduce the Triple Action Stance/Swing Control ankle joint. This new component offers high stiffness in the coronal and transverse planes, and is intended for individuals with neuromuscular pathologies.