By understanding how military medicine has evolved and adapted over time, modern practitioners can better appreciate the need to question convention, advance research, and rapidly integrate beneficial new technologies into medical care.
By Christine Miller, DPM, FACCWS, Ashley Finn, and Emily Delzell
Lower extremity practitioners are constantly being reminded that what they think they know about injury prevention is only part of a bigger picture. This time it’s the diabetic foot care community’s turn to wonder just how much they have yet to learn about the mechanisms underlying ulceration.
Jordana Bieze Foster, Editor
Partial foot amputations may not offer a biomechanical advantage over transtibial amputations if the metatarsal heads cannot be retained, and some experts suggest amputation level should be selected based on probability of wound healing instead. But others disagree.
By Cary Groner
Study findings and anecdotal reports suggest that newer-generation total ankle replacement can match or exceed ankle arthrodesis when it comes to gait and range of motion, but neither procedure returns gait to normal. Implant survival has also improved, but continues to be a challenge.
By Barbara Boughton
Total hip arthroplasty can significantly improve quality of life in obese patients, but high body mass index is also associated with higher rates of complications and readmissions than in normal-weight patients. The emerging subgroup of super-obese patients poses additional challenges.
By Raghav Rajgopal, MD, and James L. Howard, MD, MSc, FRCSC
Opportunistic microorganisms called biofilms constitute an age-old diabetic wound care problem that defies traditional antimicrobial therapies. Experts believe interventions customized to individual patients based on molecular diagnostics may be the best line of defense.
By Larry Hand
Patients with chronic refractory lower extremity tendinopathies often continue to have symptoms after exhausting most of their therapeutic options. Preliminary evidence supports the use of platelet-rich plasma in these patients, though higher-level research is needed.
By Ricardo E. Colberg, MD, and Kenneth Mautner, MD
In the Moment: Diabetes
By Emily Delzell and Jordana Bieze Foster
Practitioners often deem all areas of elevated peak plantar pressure in patients with diabetes at some risk for ulceration. A study published in September, however, suggests this risk varies with the specific location of pressure, and investigators say findings highlight the importance of monitoring plantar pressure as part of preventive care.
Clinicians should carry out quantitative vibration testing for sensory loss in patients at risk for diabetic neuropathy at the hallux, according to research that confirms the hallux undergoes greater sensory loss than the fifth metatarsal, an alternate location for vibration testing.
Diabetic neuropathy is associated with increased levels of intrinsic foot muscle deterioration, which may contribute to foot deformity and ulceration, according to research presented in September at the annual meeting of the American Society of Biomechanics in Omaha, NE.
In the Moment: Knee
By Jordana Bieze Foster
Knee osteoarthritis researchers are taking a closer look at the factors that influence knee adduction moment (KAM) and also considering the contributions of sagittal plane variables, as illustrated by studies presented in September at the American Society of Biomechanics (ASB) annual meeting in Omaha, NE.
Female athletes with low neurocognitive scores are more likely than those with higher scores to demonstrate altered landing mechanics consistent with elevated anterior cruciate ligament (ACL) injury risk, according to findings that could have implications for concussion management.
Patients with patellofemoral pain (PFP) have less medial longitudinal arch excursion during stair descent than healthy individuals, according to a Brazilian study that may help explain the effects of foot orthoses in patients with PFP.
Unlicensed providers continue to receive unauthorized payments for O&P services from the Centers for Medicare & Medicaid Services (CMS), according to a study released in September.
Irvine, CA-based Freedom Innovations announced in October that it will partner with Vanderbilt University in Nashville, TN, and the Rehabilitation Institute of Chicago to commercialize a first-generation prosthesis that uses control systems that mimic the human leg’s power and gait.
Redmond, WA-based Pro-Tec Athletics announced in September that it has re-signed Scott Jurek for an additional two years to its team of professional athletes. Jurek, a champion ultramarathoner who has been on the Pro-Tec team for more than seven years and is author of the New York Times bestseller Eat & Run, will work closely with Pro-Tec to help educate runners about recovery and performance.
A Russian orthopedist at the Saint Petersburg State Paediatric Medical University combined data from Delcam’s iQube scanner with 3D spine and posture analyses and then used the company’s software to create custom orthotic insoles for children with locomotor disorders, Birmingham, UK-based Delcam announced in October.
The OA Restore knee brace from Ottobock utilizes a rigid frame and unique hinging to help stabilize the knee, relieve symptoms, and delay more aggressive treatment for patients with mild to moderate medial or lateral knee osteoarthritis, ligament or cartilage damage…