Lower Extremity Review
Mobility and balance deficits in patients with lower extremity impairments are significant factors for decreased quality of life. To improve outcomes for these patients, clinicians need measures that are evidence-based and scientifically validated; in other words, there is a need to measure things that matter.
By Michael Rowling, BS
Before pronouncing what I predict will be the single most significant change in foot and ankle surgery in coming years, it’s essential to look back. I asked an orthopedic colleague what he thought the most significant change in orthopedics was over the past 25 years, and he replied, “locking plate technology.” I agree.
By Patrick A. DeHeer, DPM
My perspective on the future reflects my professional interest in lower-extremity injuries and conditions that can be treated by knee braces and by ankle-foot and knee-ankle-foot orthoses. An aging population and other market demographics seem to indicate there is an increasing need for braces; new manufacturing methods, including interesting composite materials and 3D printing, seem to point toward a future of technical innovation.
By Rick Riley
Georgia Institute of Technology initiated its Masters of Science in Prosthetics and Orthotics (MSPO) program in 2002, knowing that considerable advances in the profession would be possible if research was an emphasis in clinical education. Students entering the program came with added bases of knowledge, dominated by…
By Geza F. Kogler, PHD
Modern day times not only see us living longer, but enjoying a wide array of advances in lifestyle, medicine, health, and social care, as well as the fast-paced changes in technology. Currently, 13% of the global population is over age 60, a figure which is increasing by 3% each year.1
By Sarah A. Curran, PhD
Prosthetic and orthotic clinical care involves using custom-made devices to assist in the rehabilitation of people with physical impairments and disabilities. As such, it has long relied on the craftsmanship of prosthetists and orthotists. Although the results of such craftsmanship can be of tremendous benefit to the patient…
By Stefania Fatone, PhD, Ryan Caldwell, CP, FAAOP, and Julia Quinlan, PhD
The foot ranks high among the most ill-constructed elements of the modern human musculoskeletal system—an observation that necessarily begs the question: Why is this so? Upright, bipedal gait is the defining characteristic of our lineage; humans and our immediate ancestors have been practicing it for at least 5 million years. Why hasn’t evolution perfected this hallmark adaptation?
By Bruce Latimer, PhD
While many states have rushed to legalize cannabis, evidence for its medicinal use remains ‘paltry.’ However, physicians must be willing to talk with patients who want to use it. With medical and recreational cannabis legal across most of the United States and Canada, patients are turning to the drug as an alternative treatment for a wide range of ailments, including arthritis and other types of joint pain.
By Nicole Wetsman
Strategies for preventing running-related injury are lacking. These authors examine the evidence supporting use of musculoskeletal clinical assessments to predict runners at risk. Injury in runners is common, affecting 19.4 to 94.4% of runners annually.
By Shefali M. Christopher, Jeremy McCullough, Suzanne J. Snodgrass, and Chad Cook
Patients are unaware or reluctant, and some providers hesitate to engage in what can be a burdensome prescribing and procuring process—helping explain why uptake of this valuable preventative is disappointing. As allied healthcare professionals, we are, of course, acutely aware of the ever-growing diabetes epidemic in the United States.
By Erick Janisse, CO, CPED
5.5 million children and adolescents are injured playing sports annually. Most of these injuries are preventable, the CDC says. More than 30 million children and adolescents participate in organized sports in the United States; according to the Centers for the Disease Control and Prevention (CDC), that number is on the rise.
By Warren J. Potash
New research invigorates arguments about limb salvage vs. more proximal amputations. A recent paper from researchers in Australia has reignited the ongoing debate about the relative merits of partial-foot versus transtibial amputations, particularly in diabetes patients.
By Cary Groner
Limited research into electromagnetic and ultrasound bone stimulation devices complicates efforts to determine efficacy. For the majority of people, lower-limb fractures and fractures in other parts of the body heal well and reliably. However, some people experience complications that may cause significant harm.
By Nicole Wetsman
For help limiting the number of opioid tablets you prescribe—and to still treat postop pain successfully—turn to practice guidelines, evidence from the literature about local and regional anesthesia techniques, and constraints of the law.
By Robert G. Smith, DPM, MSc, RPh, CPed, CPRS
Taping is a mainstay of preventive foot blister management in athletes and active people. Its use is based on the premise that rubbing causes blisters, and that tape protects the skin from this rubbing and/or provides thermal insulation from the heat generated by rubbing.
By Rebecca Rushton, Bsc(Pod)
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