September 2018

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Cover Story


Diabetes, Its Impact, and Protection of the Diabetic Foot

Offloading is key to preventing small concerns from becoming life-threatening, but adherence remains less than optimal. The not-so-secret truth: diabetes and its precursor, prediabetes, have reached epidemic status in the United States: More than 100 million Americans are living with the disease.

By Janice T. Radak

 

Guest Editorial


The DFU Dilemma: Is the Total Contact Cast a True “Gold Standard”?

In March 2017, McGuire and Sebag wrote: “Early diagnosis and intervention for diabetic foot wounds is essential for the prevention of complications associated with these ulcers. We are all familiar with the term ‘the golden hour’ with respect to the first 60 minutes after the onset of a stroke or cardiac arrest.

By Harry L. Penny, DPM, DABPM, FAPWHc

Feature Articles


Diabetes Self-Care Adherence: Whose Responsibility Is It? What’s a Clinician’s Role?

As an expert, specialist, trained foot and ankle physician, you have worked hard for your place in the medical landscape, your degree and your confidence. You think you do your job well, but what if you are not getting through to your patients to the extent you thought you were? Over the years, I have prided myself on being an educator.

By Richard Schilling, DPM, FACFAS

People with Diabetes Foot Complications Do Not Recall Their Education: A Cohort Study

Podiatrists play a large role in education for the prevention of foot complications in people with diabetes. Subsequently, podiatrists also regularly teach self-management strategies for people with or without foot complications relating to their diabetes. Current diabetes guidelines recommend education provision; however…

By Julia Yuncken, Cyclie M. Williams, Rene Stolwyk, Terry P. Haines

Pes Anserine Tendino-Bursitis: An Underdiagnosed Cause of Knee Pain in Middle-Aged and Older Patients

With an aging population that is increasingly overweight, a growing number of patients present to providers with a chief complaint of “knee pain.” Successful treatment of these individuals depends on making the correct diagnosis. Conventional thinking is that knee pain in middle-aged or older patients is due to the degeneration of the articular cartilage and/or the tearing of the menisci.

By Donald C. Pompan, MD

Barefoot Training Is Not Just for Barefoot Runners

On January 17, 2011, The New York Times published an article titled “Close Look at Orthotics Raises a Welter of Doubts.” Responding to the writing and research of Benno Nigg, it called into question much of the anecdotal information we provide to our patients when prescribing footwear and foot orthotics.

By William Smith, MSPT, C.Ped.

Advancements in Wound Healing Management

Skin trauma to the lower extremities—blisters, lacerations, incisions, and punctures—are common for those participating in athletic and recreational activities and are seen every day in clinical care settings. A foot ulcer, an open sore on the foot, is a more serious form of skin trauma or wound that occurs, often brought on in an environment compromised by diabetes or any…

By Keith Loria

Botox® Injection: Not Just for Celebrities’ Furrows and Wrinkles

When people hear the word “Botox,” their immediate associations might be with facial injection as an anti-wrinkle treatment or magazine gossip on the latest celebrity to suffer a “botch job” from one-too-many injections. Prior to the modern use of this acetylcholine-blocking neurotoxin, no one other than medical professionals who used it to treat their patients really knew what Botox is.

By Benn Jason Scott Boshell, MSc, BSc (Hons)

From the American Podiatric Medical Association 2018 Annual Meeting

2018 Washington, DC – By Nicole Wetsman


Low Cost Insulin Spray Improves Healing of Diabetic Foot Ulcers

Spraying insulin into an open wound improves the healing of diabetic foot ulcers in diabetic patients—both type 1 and type 2, reported a poster entitled, The Outcomes of Local Flushing of Insulin on Wound Healing in Patients with Diabetic Foot Ulcers.

Foot Type Determines Effect of Orthotics on Muscle Activity

Adding a lateral bar beneath foot orthoses does not significantly alter activity in the pronator muscles in people with high-arched feet, according to preliminary data from a poster entitled, Effects of Two Types of Foot Orthoses on the Biomechanics of Participants with Cavus Feet During Walking.

Treating Vascular Malformations Without Surgery

Arteriovenous malformation can be managed non-surgically according to a poster presented by Rothman Institute podiatrists Faith Schick, PDM, and Nicholas Taweel, DPM. DPT. Their case report detailed how they resolved the patient’s symptoms and the case, highlighting the opportunities for non-operative treatment in this condition.

Office-based Toe Amputations Are Safe and Efficient

As patients seek more affordable care options, moving surgical procedures from the hospital-based operating room to less expensive, more convenient locations is one tactic being explored. But can such procedures be done safely in these outpatient settings? New research from Podiatrists in the Department of Surgery at the Southern Arizona Veteran Affairs Health Care System provides evidence that they can…and that patients like the convenience.

Negative Pressure Wound Therapy Creates Positive Clinical Outcomes in an Outpatient Setting

A new, disposable negative pressure wound therapy (NPWT) system effectively reduced the volume of varied wound types on four patients in an outpatient setting, reported Windy Cole, podiatrist at University Hospitals Ahuja Medical center, in a poster entitled, Management of Small, Lower Extremity Wounds in the Ambulatory Setting Using a Disposable, Mechanically Powered Negative Pressure Wound Therapy System.

New Products


Low-Temperature Thermoplastic Made in U.S. 

Since its inception in 1981, JMS Plastics Supply has been committed to partnering with its orthopedic customers for product satisfaction, including plastic materials, covering and cushioning materials, and equipment and supplies. New from JMS Plastics is a low-temperature thermoplastic for splinting, which JMS reports to be the only low-temperature plastic made in the U.S.

Bonapeda FORS-15 Off-Loading Insole

The new FORS-15 Off-Loading Insole from Bonapeda Enterprises is designed to gently and consistently offload targeted plantar surfaces without edge effects. The multilayered Poron insole is durable, elastic, and crush resistant; soft, low-density Poron is closest to the foot and high-density Poron is underneath for support.

Air Ankle Sleeve

The Air Ankle Sleeve is the newest addition to the foot and ankle support product line offered by Elite Orthopaedics. The Air Ankle Sleeve is designed to be used while ambulating to help support treatment of plantar fasciitis, heel pain, and Achilles tendonitis. The sleeve is constructed of soft, breathable fabric that encloses connected pneumatic cells located under the foot arch and…

Apex SelectFlex Rx Adjustable Orthotic

Apex Foot Health Industries introduces SelectFlex Rx, described as the first-ever adjustable orthotic. SelectFlex Rx, powered by iFlex technology, was designed by engineers at Apex Foot Health to relieve foot pain while improving performance. Users can easily adjust the orthotics to match activity level throughout the day by simply turning a key.

Cascade Dafo JumpStart Softback

Cascade Dafo, a manufacturer of pediatric lower-extremity braces and creator of the original DAFO (Dynamic Ankle Foot Orthosis), has added the JumpStart Softback to its Fast Fit line of prefabricated braces. This AFO is designed to provide lightweight, comfortable control of mild to moderate toe walking and knee hyperextension.

Hip Surgery Preparation Book

OPTP and author Adriaan Louw PT, PhD, CSMT, have released the latest book in their patient education series: Your Nerves Are Having Hip Surgery is a neuroscience education book that helps prepare patients for their hip surgery; explains how nerves react before, during, and after the surgery so they can understand what to expect; and reveals key recovery process strategies.

British Luxury Footwear Available in U.S.

Created by the founder of shoe brand Lisa Kay London, Sole Bliss uses 5 years of research and development to produce stylish footwear designed to accommodate women who have bunions. The British footwear is now available in the U.S. The patent-pending Juanet Technology provides an invisible stretch panel inside each shoe to support the bunion area, while…

Graduated Compression and Containment Garment

Sigvaris introduces Secure, an affordable, innovative, ready-to-wear garment featuring graduated compression and containment properties, which is designed to manage advanced venous edema, lymphedema, post-surgical edema, and general edema. This garment maintains and delivers more graduated compression (compression profile) than…

Össur Formfit Pro 3D Compressive Knit Solutions

Introducing Össur Formfit Pro, a new 3D compression knit line by Össur, designed for people who suffer from various musculoskeletal conditions or ailments yet strive to remain active. Össur‘s Formfit Pro range includes Formfit Pro Knee for compression and patella support; Formfit Pro Knee OA, providing pain relief and…

The Neuropathic Walker is your solution

The Neuropathic Walker is a more advanced and comfortable solution to the CROW Walker. The Neuropathic Walker is integrated with custom molded 3/16” solid polypropylene and 1/4” Aliplast lining with the same trim lines as a CROW Walker. We use high-quality leather that is molded over the solid polypropylene.

Stop Morning Heel Pain with Medi-Dyne ProStretch NightSock

New on the market from Medi-Dyne is the ProStretch NightSock. The product is designed to help alleviate heel pain associated with plantar fasciitis, Achilles tendonitis, calf muscle cramps, and runners’ cramps. By keeping the foot in a slightly flexed position, the ProStretch NightSock comfortably elongates the muscles and…

Data-Gathering Performance Treadmills

Mobius, AMTI’s new line of performance treadmills, comes in two models: one fixed-tilt and one inclinable, capable of a 25% gradient. Both models have two independent 8800N-capacity force platforms, and a frame engineered to achieve the highest possible natural frequency, with the goal of providing industry-leading data quality.

Kinetic Research Flagship Ankle-Foot Orthosis

The Noodle is Kinetic Research’s flagship ankle-foot orthosis.  This patented technology creates a quick and simple solution for drop foot.   What makes this ultra-lightweight AFO special is its next generation of carbon fiber properties that allow it to maintain dynamic motion and energy return.

Industry Snapshot

Noteworthy products, association news, and market updates