April 2013

LER03-13Cover-smCover Story

Ready Patient One: Exer-gaming for rehabilitation

Video gaming technology is finding its way into clinical practice, and research supports its effectiveness for improving balance, strength, and function. But studies also suggest some patient populations may be more responsive to exer-gaming than others.

By Samantha Rosenblum

Editor Message

Out on a limb: Ode to The Ogler

The best mentors have so much to teach us that sometimes it takes years for us to realize just how much we’ve learned. I’m reminded of that every time I sit down to write this column, but it’s hitting home especially hard right now.

Jordana Bieze Foster, Editor


Microfracture surprises tarnish the experience

US orthopedic surgeons perform more than 25,000 microfractures annually, making the procedure the most common marrow-­stimulating technique used for repair of the cartilage defects that often affect active individuals.1 Although microfracture is a single-stage, low-cost intervention that requires only surgical time and common surgical tools, it requires…

By Emily Delzell

Orthosis use in children with Down syndrome

The literature on preschool-aged and older children with Down syndrome tends to be consistent with conventional understanding of orthotic principles, but in very young children clinical decision-making about orthoses must also encompass  neuromotor implications.

By Julia Looper, PT, PhD

Diabetic ankle fractures: Surgical considerations

Pittsburgh researchers found that patients with diabetes have higher complication rates than nondiabetic patients following open surgical management of ankle fractures, but also that the rate of major complications in the diabetic patients was relatively low.

By Robert W. Mendicino, DPM, FACFAS; Alan R. Catanzariti, DPM, FACFAS; Brian Dix, DPM; and Phillip Richardson, DPM

Bone bruises and risk of knee osteoarthritis

Bone bruises are commonly associated with anterior cruciate ligament (ACL) tears, but researchers are only beginning to understand the potential clinical significance of these chondral lesions with regard to knee osteoarthritis (OA) and preventing ACL injury recurrence.

By Cary Groner

Poststroke bone changes in patients who use AFOs

The medical literature suggests that changes in bone density and other bone characteristics after stroke persist after patients have regained ambulatorystatus. Whether ankle foot orthoses have a shielding effect on bone remodeling, however, remains unclear.

By Kyle Sherk, MS, CPO


In the Moment: Knee

By Jordana Bieze Foster

BMI and TKA: Obese patients do benefit from surgery

Reluctance to perform total knee arthroplasty (TKA) in obese patients may be unwarranted, at least when it comes to functional outcomes, according to multiple studies presented in March at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS).

Improvement in knee OA symptoms persists two years after PRP injection

Platelet rich plasma (PRP) injection in patients with mild to moderate knee osteoarthritis is associated with significant improvement in pain and function, according to research from Milan, Italy, presented in March at the AAOS meeting.

Some athletes take years to come back from meniscal allograft transplantation

Meniscal allograft transplantation can help high-level athletes return to sports—but it might take a while, according to research from Rush University Medical Center in Chicago presented in March at the AAOS meeting.

Postoperative femoral nerve blocks sap quadriceps strength, increase risk of falls

Femoral nerve blocks significantly impair quadriceps strength when used for postoperative analgesia after total knee arthroplasty (TKA) and anterior cruciate ligament (ACL) reconstruction, according to separate studies presented in March at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS).

In the Moment: Ankle

By Jordana Bieze Foster

Replacement revisited: Positive outcomes include younger patients

Total ankle replacement (TAR) is growing in popularity, as an increasing number of studies suggest that the procedure’s outcomes rival those of ankle fusion—perhaps even in patients previously thought to be poor candidates for TAR.

As in football, Achilles rupture means end of career for many NBA athletes

Fewer than half of National Basketball Association (NBA) players who suffer a complete Achilles tendon tear return to play for more than one season, and 39% never return to play at all, according to research presented in March at the AAOS meeting.

AFOs affect plantar flexion strength in some high-level volleyball players

Volleyball players without ankle instability who wear hinged stirrup ankle foot orthoses (AFOs) may experience decreased plantar flexion strength as a result, according to research from Loyola University in Maywood, IL.

Market Mechanics

Orthopedist Jacquelin Perry dies, leaves legacy of innovative biomechanics work
Jacquelin Perry, MD, DSc (Hon), died on March 11 in her home in Downey, CA. She was 94, and worked until near the end of her life at Los Angeles’s Rancho Los Amigos Medical Center, where she cared for patients ...
New center aims to prevent sports injuries
This month orthopedic surgeon Lyle J. Micheli, MD, opened the doors to The Micheli Center for Sports Injury Prevention in Waltham, MA. Micheli is director of the Division of Sports Medicine at Boston Children’s Hospital, and clinical professor of orthopaedic surgery ...
Levy & Rappel offers free 3D scanners
Levy & Rappel is offering a free Delcam iQube mini scanner to practitioners who dispense a high volume of custom orthotic devices. David Kramer, owner of Saddle Brook, NJ-based Levy & Rappel, said the scanners will increase practitioners’ efficiency and save ...
BOC wins nod for sales, customer service
The Board of Certification/Accreditation (BOC) won a Stevie Award for sales and customer service at the seventh annual Stevie Awards ceremony, held in late February in Las Vegas, NV. BOC won the award as a result of changes made after a ...
CMT research consortium looks for a cure
The Charcot-Marie-Tooth Association (CMTA) is continuing progress with its STAR (Strategy to Accelerate Research) Initiative, which it created to accelerate CMT research. The STAR initiative, which has recently reached several research milestones, provides a structure for collaboration among an international consortium ...
High-tech boot debuts at AAOS meeting
DJO Global introduced its Air­Select suite of high-performance walking boots in late March to an audience of lower extremity professionals at the Annual Meeting of the American Academy of Orthopaedic  Surgeons, held in Chicago. Part of DJO Global’s Aircast brand, the ...
APTA section funds geriatrics research
The American Physical Therapy Association (APTA) announced in April a $50,000 donation to the Foundation for Physical Therapy from the APTA’s Section on Geriatrics. The Section on Geriatrics earmarked $25,000 for the Marilyn Moffat Endowment Fund for Geriatric Research, which was ...
Researchers investigate intelligent textiles
The Qatar National Research Fund in Doha announced in March an award of $2 million to an international group of researchers in the US and Qatar. The scientists are examining the use of new technology incorporated into specially made socks designed ...
CuraMedix, Strutz sign distribution deal
Lincoln, RI-based CuraMedix, and Strutz, based in Englewood Cliffs, NJ, inked a deal to partner in the distribution of their products to orthopedic, sports medicine, pain management, and podiatric and chiropractic practices, as well as physical therapy and rehab facilities. This ...
Dralla calls for 2013 grant submissions
The Rockaway, NJ-based Dralla Foundation announced in March that it’s beginning its second year of grant awards to organizations that reflect its newly updated mission statement of supporting “programs geared toward providing an environment for children and adults with physical ...


For practitioners frustrated with the limitations of leather, Bracemasters offers the DRAFO DRG Flex, the latest addition to the DRAFO (dynamic response ankle foot orthosis) Gauntlet Series of hygienic, durable custom products. The DRAFO DRG Flex provides a balance between ...
China-Gel Tube 2 Go
China-Gel introduces a new convenient 2-oz travel tube of its topical pain reliever. The Tube 2 Go features the original China-Gel formula and comes with a clip for attaching to a purse, athletic bag, or other accessory. Developed by a ...
Polypropylene in New Colors
Homopolymer polypropylene from Allied Plastic Supply is now available in flesh tone and black for creating prosthetic definitive sockets. Both colors are available in 1/2” thickness. Polypropylene combines an excellent strength to weight ratio with a high degree of stiffness ...
Breakaway Athletic Shoe
Ektio Athletic Shoes announces the launch of its new shoe, the Breakaway, which improves upon previous models with regard to comfort, performance, and ease of use. Endorsed by former National Basketball Association players Rick Barry and John Starks, the Breakaway ...
Cold Roller Muscle Therapy
Trigger Point Performance Therapy introduces the Cold Roller, designed to target muscles with a combination of myofascial release and cold compression. After two or more hours in the freezer, the gel-filled stainless steel roller maintains an effective cold temperature for ...
Diaped Flux-200
Algeos USA announces the launch of the Diaped Flux-200, a pocket-sized vascular Dop­pler device for detection and evaluation of blood flow in the feet of patients with diabetes. This hand-held, portable device can be used in or out of the ...
Pressure Positive Raw-Dock
The Pressure Positive Company announces the addition of The Original Raw-Dock, in collaboration with Raw Health International, makers of Raw Heat and Raw Ice topical analgesics. The Raw-Dock slips into the large end of the Backnobber II and locks in ...
Tri-Panel Knee Immobilizer
Elite Orthopaedics introduces the Advantage Tri-Panel Knee Immobilizer for immobilization of the knee joint postoperatively or after injury. The brace is fully adjustable to accommodate varying leg circumferences and available in three lengths. It may be dispensed by orthopedic surgeons, ...