Los Angeles Podiatrist

a proud provider organization for UCLA Medical Group

Diabetic Foot Wounds

by Dr. Sydney K. Yau - December 5th, 2013

Diabetic Foot Wounds as Discussed

by Podiatrist Dr. Sydney K. Yau, DPM

In the United States, diabetes affects approximately 25.8 million people and up to 25% of those people develop a foot ulcer during their lifetime.  Diabetic wounds that are left  untreated may lead to an amputation.  In fact, one in five people with a diabetic ulcer may eventually require an amputation and diabetic wounds are by far the most common cause of non-traumatic lower limb amputations.

Diabetes affects the foot in multiple ways that increase the risk of ulceration.  Diabetes affects the musculature of the foot and can cause an imbalance in the foot and change the distribution of pressure across the foot.  Areas not meant to bear-weight may take increased stress and break down.  This is further complicated by neuropathy, or a lack of protective sensation to the foot.  Patients with a lack of sensation from diabetes are unable to sense pain and may develop a break in their skin without even knowing it.

Once ulceration occurs, it is important to have it treated quickly.  Any opening in the skin increases the patient’s risk for infection.  If the foot infection spreads too quickly, amputation may be necessary to salvage the limb and life of the patient.

Patients presenting with a diabetic foot ulcer should be tested for adequate circulation to the foot, as diabetes can also affect the circulation into foot.  Adequate blood flow is needed to ensure proper healing of the wound – without blood flow the wound will not heal.  Infected wounds need to be drained of any infection and treated with antibiotics.  There will always be surface bacteria on the wound, but keeping the bacterial load in wounds down is one of the keys to healing a wound.  Debridement of a wound, which means to cut away any dead tissue surrounding or within the wound, is one of the key ways to reduce the bacterial load in a wound.

Diabetic Foot Wounds Treated by Los Angele's Podiatrists

Diabetic Foot Wounds Treated by Los Angele’s Podiatrists

After making sure there is circulation and that any infection is well controlled, one of the mainstays to treating a diabetic foot ulcer is to offload it.  Since diabetic foot wounds develop often due to repetitive stress in a particular area, our goal is to distribute the pressure differently in order to heal the wound.  Many modalities can be used for this and each modality can be beneficial.  Modalities can include a total contact cast, walking cast, healing sandal, or orthotic.  Some patients may require surgery either to realign deformities or remove bony prominences that may be causing increased pressure in the area of concern.

The prevalence of diabetes is increasing and with it diabetic foot wounds.  Diabetic foot wounds may lead to amputation, so it is important to have them treated promptly by a professional.   Podiatrists are experts in the field of diabetic foot wounds and we not only evaluate and treat wounds, but we aim to prevent them from recurring once they are healed.

Kobe and Curry: Podiatrist Weigh In on Foot and Ankle Injuries

by admin - November 22nd, 2013

Kobe Continues to Recuperate, Curry Expected to Start

After making three appearances in practice, five-time NBA champion, Kobe Bryant is not expected to start against the Golden State Warriors tonight. The Los Angeles Lakers shooting guard is still adjusting to his Achilles injury. Though Bryant was medically cleared to play just a few days ago, he is still not 100 percent to perform on the court. He is taking strides to making a full recovery, as he participated in two full-contact practices and live scrimmages with the team. His teammates and coaches see this as a sign that he could be back in action, but like any foot and ankle injury, the road through rehab is a lengthy process.

The seven-month old injury made its first sign of slowing down the 16-year veteran, as Bryant missed Thursday’s practice due to soreness in his injured, left foot. The Lakers are set to host the Warriors tonight where their four-year point guard Stephen Curry looks to return from his own setback.

Curry went down and slammed the left side of his face on the court Monday, suffering a mild concussion in a victory over Utah. He looked like his usual self as he participated in non-contact drills with the team on Thursday. With Bryant out, Curry can threaten the Lakers with some heavy artillery shots from beyond the three-point line.

Curry’s own ankle injuries suffered last season could be a factor and limit his playing time, should he experience dizziness or fatigue, which could dampen his mobility. He went through a scare earlier this month when he injured his left ankle, but MRI scans came back negative, only reporting a bruised bone.

Lakers’ head coach Mike D’Antoni told the Los Angeles Daily News that Bryant was a little tired following Wednesday’s practice. Bryant concurred and said that he felt limited in physical explosiveness, which in his case is a necessity for lateral movement and jump shot abilities should he contemplate playing tonight.

Our own foot and ankle specialist, Dr. Bob Baravarian told the San Francisco Chronicle that Bryant is an elite athlete who can take a much more aggressive approach with his rehab. “If he was a normal athlete at seven months, he’d be back to normal athletics,” said Dr. Baravarian. “The problem is, he’s an elite athlete. That’s what is amazing about it.”

Though Dr. Baravarian is still unsure if Bryant is capable of engaging in full-game contact. His ankle and Achilles may not be strong enough to cope with the explosive first step that Bryant takes when he drives to the basket. He is known for his ability to create space and push off defenders without hesitation to shoot his signature fade away jump shot.

Bryant may be medically cleared to play by their staff, but his coaches will determine when he is able to start without aggravating the ankle and Achilles. Even though Bryant is not expected to start tonight, we can look forward to seeing the 15-time All Star returning to strike fear in his opponents with his presence very soon.

Gearing Up Like an Ironman

by admin - October 28th, 2013

Earlier this month, the 35th Ironman World Championship was held in Kona, Hawaii. Some of the best athletes in the world compete in this event every year, a day-long race that features a 2.4-mile swim, 112-mile bike ride, and a 26.2-mile foot race (a full marathon). This year’s winner, Frederik Van Lierde, finished the race in 8:12:29. All of the 2,100 elite athletes who competed in this race were impressive, but what really stuck out in Sports Illustrated’s recap of this year’s Ironman race was the high level of attention paid to the process of gearing up.

As author Tim Newcomb points out, “preparing for a 140-mile long race started long before race day.” He points out the racers’ attention to equipment, making sure that they had the proper athletic equipment ready to go before the race began. It just goes to show how even the best-conditioned athletes rely on the right gear to get them to the finish line. There is a lesson here for even the novice athlete: if you want to finish the race, you had better make sure you gear up right.

You may not be looking to compete in a marathon, but if you want to get the most out of your run, it’s important that you wear the right shoes. As podiatrists, we routinely fit our patients with advanced custom orthotics designed specifically for their feet. Not everyone needs a custom orthotic, although everyone can benefit from the protection and support that these devices provide. If you are in the market for running shoes, you should make sure they fit properly and provide adequate arch support. If you have any existing foot conditions, such as flat feet, you should consult a podiatrist to help prevent possible injuries. There are many athletic orthotics that can custom-molded to your feet, protecting the vulnerable parts of your feet and correcting any improper foot movements that could lead to injury.

Our patients run the gamut from regular people to professional athletes at the top of their game. But regular activity is important for everyone’s health. No matter what level you’re at, we want to know: how do you gear up for your exercise?

Osteochondral Lesion Takes Los Angeles Dodgers’ Matt Kemp Out for 2013 Post Season

by admin - September 30th, 2013

Matt Kemp Out with an Osteochondral Lesion

 

Matt Kemp, who is an outfielder for the Los Angeles Dodgers, will be unable to help the Dodgers in the post season this year due to an MRI showing swelling in one of the major weightbearing bones in Matt Kemp’s ankle, the talus. Kemp initially injured his ankle in a play at the plate against the Washington Nationals on July 21. After missing 52 games on the disabled list, he returned to play on September 16th but was held out of Saturday’s game due to soreness in his ankle. This prompted an MRI that revealed swelling in the talus (osteochondral lesion), taking Kemp out of the lineup in the post season.

What does swelling in the ankle (talus) mean?

On an MRI after an ankle sprain injury, swelling in the talus typically will mean that there is some cartilage damage in the bone, called an osteochondral lesion. When an ankle is sprained, a number of different structures can be injured. In addition to the ligaments and tendons around the ankle being torn, occasionally a small piece of cartilage can chip off of the talus bone. This cartilage damage is usually not readily seen on x-rays, but will often show up on MRI as bone swelling. A CT scan may be useful in determining the size of the osteochondral lesion.

What is the treatment of an osteochondral lesion?

 

Picture of Talus Bone and Cartilage

Picture of Talus Bone and Cartilage

Treatment of an osteochondral lesion depends on the location and severity of the lesion. Lesions on the inside, or medial aspect, of the talus are usually deeper and more stable. Lesions on the outside, or lateral aspect, of the talus are usually shallower and wafer shaped – making them less stable. Osteochondral lesions can be classified as compression or bruising of the bone (stage I), partially detached (stage II), completely detached but non-displaced (stage III), or completely detached and displaced in the ankle joint (stage IV). Stage I, II, and lateral stage III lesions are best treated conservatively with a period of immobilization that includes a non-weightbearing below knee cast for six weeks. If pain persists after this period of immobilization, surgery may be indicated. Medial stage III and stage IV lesions are best treated with surgery.

 

What are the surgical options for an osteochondral lesion?

There are a number of procedures that can be done depending on the size and depth of the osteochondral lesion. Before surgery, the size and depth of the lesion should be determined with a CT scan to help with planning the appropriate procedure.

Microfracture surgery

Cartilage in general has a poor blood supply and it has poor healing potential. Microfracture surgery involves drilling holes into the lesion to stimulate blood flow in the area and promote the formation of fibrocartilage. This procedure is fairly minimally invasive as it is often done through a scope. This procedure has good outcomes for smaller lesions.

Cartilage graft

A cartilage graft can be placed in the area of the osteochondral defect to effectively replace damaged cartilage. This method is usually reserved for lesions of about 1 cm in diameter. In this procedure, the osteochondral lesion is punched out and replaced with a cartilage graft of identical size from a donor. For the best results, a graft is taken from the similar bone in which the osteochondral defect is present as to recreate the anatomic contour of the joint as best as possible. This is best done with a cadaver bone that matches the affected ankle. Cadaver bones should be used within 14 days of it being harvested and should be fresh, not frozen. Frozen grafts will deteriorate cartilage cells and reduce the ability of the graft to successfully incorporate into the host.

Stem cells

Mesenchymal stem cells make up about 2-3 % of all blood cells in bone marrow and they have the ability to differentiate into different types of cell types if placed in the right environment. They also have the ability to stimulate new blood vessel growth, which is important in developing avascular tissue such as cartilage. Stem cells can be separated from bone marrow that is harvested from the body and either injected into the ankle joint or placed over the osteochondral lesion itself in a gel form with a scaffold graft. The stem cells will then differentiate into cartilage due to the growth factors and signals that are present in the environment in which they were placed.

What should Matt Kemp do?

The current treatment plan for Matt Kemp is immobilization in a non-weightbearing cast. This likely means that the lesion is either a stage I, II or lateral stage III lesion and likely to heal with conservative treatment. It is very important to rest this injury because the talus bone does not have a great blood supply. Due to this, any additional pressure that is placed on the ankle may cause the lesion to get bigger and ultimately cause arthritic changes in the future. A CT scan would be useful in evaluating any cartilage or bone defect that may be present in the ankle. Should he continue to have pain after this period of immobilization, surgery may be indicated. After immobilization, a period of rehab is needed. Range of motion and strengthening exercises are done to help strengthen the ankle. Assuming conservative treatment works, Matt Kemp should be back for spring training in 2014 to help the Dodgers reach the post season again.

Hammertoe Surgery: Santa Monica Foot Surgeons Reduce Infections

by admin - August 30th, 2013

Santa Monica Foot Surgeons Reduce Infections

With Advanced Techniques for Hammertoe Surgery

“Walking on pins and needles” may cause temporary pain, but walking on hammertoes can cause a much more serious type of foot pain. Untreated hammertoes can lead to deformities, ulcerations and activity limitations. Not only that, but hygiene is made more difficult for older patients suffering from hammertoes. However, there are several forms of treatment, including hammertoe surgery, which can provide relief for painful conditions that continue to haunt patients.

 

Hammertoe is a deformity that affects one or more of the lesser toes. The toe buckles at the joint where the toe connects to the rest of the foot. The first bone of the toe, the proximal phalanx, contracts upwards while the rest of the toe points down. The big toe is not affected by hammertoe. There are several forms of conservative treatment, but if those fail, surgical treatment can be appointed for correcting toe alignment.

At the University Foot and Ankle institute, Santa Monica foot surgeons preform hammertoe surgery to straighten the digit’s position and a pin or screw is inserted for stability. Certain cases require removal of small bone pieces from the joint to realign the toe.

According to WebMD, when the toe muscles get out of balance, a hammertoe can form. The muscle imbalance puts a lot of pressure on the toe’s tendons and joints. Thus, pressure forces the toe into the shape of a hammerhead. The most common risk factors for developing hammertoes include:

  • Genetics

  • Arthritis

  • Toe injuries

  • Poor-fitting shoes

What can I do to prevent hammertoe?

The first thing people can do is be smart with their feet. You only get two of them, so treat them with care by checking them for irregularities and injuries. Good circulation is vital for healthy feet. Stretch your legs and feet if you have been sitting for a while. Treat them to a massage and a warm foot bath on occasion. Healthful ideas include:

  • Purchase shoes that fit both feet (one foot may be bigger than the other)

  • Measure feet regularly as you get older

  • Shoes must be sturdy and bend where the big toe bends

  • Never buy shoes that feel too tight

  • The higher the heel is the less safe the shoe

  • Check children’s feet and shoes regularly

Hammertoe Treatments:

If the middle of your toe joint is bent or the end of the toe bends down like a claw, you should seek advice for a potential hammertoe. You may be able to straighten the big toe at first, but over time the toe will no longer move and it will be painful. Conservative treatments will not correct hammertoe, but they can temporarily relieve the symptoms of hammertoe such as pain and discomfort. Common treatments include:

  • Wearing shoes with wide toe boxes for comfort

  • Avoid use of high heels

  • Soft insoles relieve pressure on the toe

  • Corn pads or felt pads can protect the joint sticking out

For extreme cases hammertoe surgery will correct the deformity when conservative treatments fail to relieve symptoms. By cutting or removing tendons or ligaments of the toe and fusing the joint together, surgery can definitively correct the deformed toe.

Benefits of Hammertoe Surgery

After surgery, patients will be able to look forward to getting back to the activities they love. Pain and discomfort are corrected and there will no no longer be any pain when walking or hiking, because the toe joints will no longer feel pressure or rub against the inside of shoes. This leads to improvement in health which, in turn, allows the patient to lead an active lifestyle. They will no longer feel self-conscious about taking their shoes off at the beach and feel comfortable walking barefoot.

If you feel discomfort or notice your lesser toes are forming into a claw-like position visit the University Foot and Ankle Institute of Santa Monica. Their team of highly trained foot surgeons come fully prepared to treat the most complex cases of hammertoe. Put an end to the pain and keep those boots strapped. Hammertoe does not have to keep you in pain forever. Discover what treatment you can have today.

Ankle Sprain

by admin - August 22nd, 2013

Ankle Sprain: When to See the Ankle Doctor

An avid athlete works around the clock for perfection on the playing field by spending countless hours training and exercising. Their feet and ankles take a beating as wear and tear increases the risk of injury. Without proper rest and nourishment, the ankle can give way at any moment. One false move and you can cause an ankle sprain. If is not a severe pain that needs immediate medical assistance, the ankle may be strained and needs time to rest and recover.

Ankle Sprains and Arthritis

Most people experience at least one sprained ankle, which is common and treatable, but multiple injuries to the ankle can result in ankle arthritis. Ankle arthritis, also known as osteoarthritis, is general wear and tear of the ankle joint. All joints in the body have a layer of cartilage that allows smooth motion in joints. Patients with ankle arthritis have degeneration and destruction of the cartilage in the joint, and when the bones grind on the joint it produces pain. As a result, the movement at the joint is not as smooth and there is often a reduction of motion that affects the patient’s ability to walk.

Ankle arthritis mostly occurs in aged people unless an individual suffers multiple injuries. Over time the weight, stress and heavy activity can degrade the cartilage. Often times the degeneration of the ankle are accelerated if the joint is misaligned. Therefore, a misaligned ankle left untreated leads to osteoarthritis. To avoid all of this pain and suffering, there are a number of things to be done at home to treat an ankle sprain.

Ankle Sprain Treatment & Recovery

According to an article on WebMD, an ankle sprain can take four weeks to six months in order to properly heal, depending on the severity of the injury.

ankle sprain before treatment from an ankle doctor

Photo of an ankle sprain before treatment from an ankle doctor

The best thing to do to treat a sprained ankle is to give it rest. Rest will give the ligaments time to relax and heal properly. Resting the joints are necessary to prevent future sprains. Do not do any strenuous activities including running, weight lifting or mobile drills that need the feet to run and cut at sharp angles.

Apply ice as often as needed to reduce pain and swelling. Your parents always told you when you were younger to put some ice on if something hurts. It still applies as an adult. Once at home, apply an ice pack for at least 15 minutes or soak the ankle in a tub of ice to reduce the initial pain and swelling. After the first application of ice, wait 15 to 20 minutes then re-apply ice for another 15 minutes and repeat the procedure until it is time to sleep. In between each session of icing it is vital not to walk or put pressure on the ankle until it regains warmth, so wait for 10 minutes after icing to walk on it.

Wrap an elastic bandage around the ankle to compress the joints and reduce swelling. This can be done after a few sessions of icing or compress the ankle while icing. If the wrap is too tight, loosen it so blood flow can circulate throughout the foot.

Elevate the ankle. In between icing, the ankle should be raised and rested on a soft pillow or cushion raised above the heart. Elevation will help drain the fluid from the ankle.

If the pain is initially gruesome take pain relievers, like extra strength tylenol or ibuprofen. This will help ease the pain while icing and elevating.

After treatment try light stretching and applying pressure. It allows the ankle joint and ligaments to regain strength and also tells the body what the limits are and how much pain there is with every movement.

When to an Ankle Doctor

If symptoms are incredibly painful or persist past a week from the initial injury, the individual should visit an ankle doctor. If it is still painful to put any weight on your ankle then it is a severe injury that needs further examination from an ankle doctor. Depending on how severe the ankle sprain appears in examination the ankle doctor will advise what needs to be done to regain strength.

Treating a sprained ankle at home is simple. The individual needs to pay attention and know how much pain and swelling there is every day after the ankle sprain. If the swelling and pain do not pass within a week or get worse, then make an appointment with a ankle doctor. Get the treatment you need to regain mobility. You are only given two ankles, do what needs to be done to keep them strong and healthy.

About the Author:

University Foot & Ankle Institute of Southern California have top ankle doctors serving the Greater Los Angeles area.

Diabetic Foot Care Guide

by admin - July 15th, 2013

A Guide to Diabetic Foot Care

As the heat settles in to Southern California, it’s important to stay alert about your diabetic foot/feet’s health. Patients with diabetes need to be especially aware of their feet. Swelling, dryness, cracking from wearing sandals and/or walking barefoot are common foot problems in the summer for people with diabetes. To be informed about how your feet are coping visiting your Los Angeles podiatrist should be a priority before hitting the beach for some cool waves this summer.

Why Worry about Your Diabetic Foot/Feet?

According to the American Diabetes Association, people with diabetes often have poor circulation and nerve damage (neuropathy) in their extremities. Diabetes reduces blood flow to certain areas of the body, especially in your limbs, and that makes it even more difficult for injuries to heal properly. Nerve damage from diabetes can cause you have difficulty feeling things with your feet, like pain or temperatures. Worse yet, sometimes the damaged nerves give constant singles of tingling, burning, and/or pain, like millions of needles, which can mask a serious foot injury. Without checking your feet regularly you may unknowingly neglect a wound that needs treatment. The Centers for Disease Control and Prevention (CDC) concluded that people with diabetes were eight times as likely to lose a leg or foot to amputation as people without diabetes!

What do I Need to do to Keep my Feet Healthy?

For diabetics, the CDC recommends a complete foot examination at least four times a year or more if you have foot issues by a podiatrist with experience in diabetic foot care. It’s necessary to check for any changes (including sores, redness or temperature changes) and wash and dry your feet every day with mild soap and warm water. After you wash and dry your feet, you will want to moisturize your feet to avoid overly dry and cracking skin which allows an opening for bacteria to invade. Take caution to ensure that you do not apply lotion between the toes to avoid fungus. An important part of diabetic foot care is to clean, clip and file your toenails straight across. It is best to do this after the nails have become soft from washing. This will help you in avoiding an ingrown toenail, which can be very painful and dangerous for a diabetic.

Wear Shoes that Fit Properly.

Because your feet are so important, ensure that you are protecting them correctly with the right shoes. Shoes that pinch, are too tight in the toes or just overall too small can do a great deal of damage, often without you even knowing. Tight, narrow shoes limit circulation to the extremities like the toes and can cause extensive nerve and even tissue, bone and ligament damage.

Select a shoe that covers and protects your foot. Sandals, open toe heels and flip flops are not great at protecting your feet from things like burns or cuts. In some cases, custom orthotics can be made to fit your feet perfectly to assist in comfortable and safe shoes. Talk to an experienced podiatrist about your shoes and discuss the specific type of shoes that will work best for your feet.

Walk Barefoot with Extreme Caution.

The beach, pool, camping grounds, boats, locker rooms, even your own house are all potential danger zones for cuts, punctures,  burns, and contact with bacteria. If you do choose to go barefoot outdoors, applying sunscreen your feet will protect from a sunburn. Cancers of the foot are among the most deadly due to the fact that it is not often spotted until the cancer is at a very advanced stage. Limit your risk of a foot melanoma by routinely examining your feet and seeing a foot doctor at the first sign of anything abnormal.

My Feet Hurt!

After a long day of enjoying the summer sometimes swelling can occur and become an uncomfortable end to an otherwise great day. Wearing support stockings and elevating your feet if swelling occurs is often recommended. If you do get a blister from all that walking, don’t pop it! Opening a blister to infection is risking serious complications for a person with diabetes. Clean and cover it with a dressing and watch it carefully. The best practice is to avoid shoes and walking until the wound or blister heals. Switch shoes and put on dry clean socks if you must continue to walk with a blister. Cuts, even small ones, must be treated immediately to avoid injection.

If you have symptoms that are recurring, painful, limit mobility or are concerning don’t hesitate to see a podiatrist. Los Angeles foot doctors are among the best and would be happy to both treat and educate you further on proper foot care techniques.

Be in control of your health. Don’t let the heat and long days keep you from enjoying the activities this summer. As long as you follow the careful instructions of your podiatrist, you will be able to enjoy this and other summers for even longer!

Orange County Podiatrist Advice: Treating Ingrown Toe Nails

by admin - June 3rd, 2013

Orange County podiatrist answers common questions about ingrown toe nails:

How do ingrown toenails happen?

Ingrown toenails commonly present in all age groups. Usually they present with a red swollen area along the side of the toe. They may or may not present with drainage from the site, but they are painful.

Why are ingrown nails so painful?

Due to local irritation of the skin along the toe nail, usually the area will swell. The local swelling increases the pressure of the skin against the solid nail plate, creating greater irritation of the soft tissue. A vicious cycle. The more you walk with an ingrown toenail, the greater the chance of the area becoming more irritated and painful.

Assuming you have an ingrown nail, how should you address it?

Usually begin by soaking the foot/toe in warm water for 10 minutes twice a day. Follow this with application of a topical antibiotic and a band aid. If the discomfort and swelling continues or increases, you need to see your local Los Angeles or Orange County podiatrist (foot doctor) or dermatologist.

When should you go see your Orange County podiatrist?

Assuming the symptoms don’t resolve and you go to your doctor, the treatment is fairly straight forward. The source of the irritation has to be removed. As we have already noted, the source of the irritation is the nail. Is it bothering the skin because of its shape, or because of the way it was trimmed? Only you know for sure.

What will the foot doctor do to get rid of the problem?

Usually, the doctor will numb the toe at its base. Once the area is numb, the offending portion of the nail is removed from the area. Rarely is it necessary to remove the entire nail plate. If this is a problem that frequently presents, often the portion of the nail that is the irritant is permanently removed through a quick surgical procedure that is performed in the office, called a matrixectomy.

To learn more about common toe, foot and, ankle problems please visit University Foot & Ankle Institute website or visit one of their 11 SoCal Podiatry Offices:  Beverly Hills, Santa Monica, Valencia, Cypress, Manhattan Beach, Sherman Oaks, West Hills, UCLA, Bellflower, Santa Barbara,  and Fullerton

Best Los Angeles Ankle Surgeons Treat Ankle Arthritis with Stem Cell Therapy

by admin - November 30th, 2012

Best Los Angeles Ankle Surgeons use Stem Cell Treatment for Ankle Arthritis

Osteoarthritis is the most common joint disease and affects more than 20 million people in the United States alone. Osteoarthritis is characterized by progressive cartilage degeneration with functional loss of motion at a joint. Although osteoarthritis can affect any joint, it most often will affect the weightbearing joints such as the knee, hip, foot, ankle, and spine. There are many contributing factors that may cause osteoarthritis, but it is most commonly caused by abnormal mechanics or loads on a joint, a mal-alignment of a joint, a previous infection in the joint, or a previous trauma to a joint.

Traditionally, osteoarthritis is treated with physical therapy, steroid injections into the joint, oral use of anti-inflammatory medication, lubrication injections, and life-style changes. For the ankle, the use of a brace may help stabilize the joint and prevent painful motion at the ankle. There are some surgical options that may help alleviate ankle pain from ankle arthritis, including ankle arthroscopy, joint distraction, cartilage replacement surgery, and spur removal. Should those preliminary procedures fail to give relief and the arthritis progresses, the end-stage treatment for osteoarthritis of the ankle is either ankle fusion or ankle replacement.

Stem Cell Treatment for Ankle Arthritis

Stem Cell Treatment for Ankle Arthritis

Although ankle fusion or ankle joint replacement surgery for ankle arthritis is generally very successful, it does come with risk factors and a long recovery period. Recently, there have been advances in the use of stem cells to treat osteoarthritis in the area of cartilage repair as a minimally invasive procedure without the need for a major open reconstructive ankle surgery. In addition, there is a very minimal chance of rejection as the cells are harvested from the patient’s own body; usually from bone marrow or fat. Stem cells have the potential to develop into different cell types, including cartilage cells. In addition, they have properties which enhance the body’s repair mechanisms such as reducing inflammation, increasing healing potential, and reducing scarring.

The benefits of using stem cells to repair cartilage in arthritic joints are many and there seem to be minimal complications with their use. Additional research is needed in the area of stem cells for use in arthritic joints in humans, but preliminary studies in humans and rat models show promising results, and we may be approaching a cure for arthritis.

Beverly Hills Foot Surgeon Revolutionizes the use of Platelet Rich Plasma Treatment for Heel Pain and Plantar Fasciitis

by admin - November 16th, 2012

Platelet Rich Plasma for Plantar Fasciitis and Heel Pain Treatment

Plantar fasciitis is a very common condition of the heel. It is the most common diagnosed cause of heel pain. It will affect about 1 million people each year. Beverly Hills Foot Surgeons has been using platelet-rich-plasma (PRP) therapy as a means of heel pain treatment for chronic plantar fasciitis for the last 3 years. The results have been increasingly promising with regards to decreased pain, increased activity, improved function, faster recovery, and increased strength. The use of PRP in the clinical setting is advantageous for its ease of use, relative availability, lack side effects, and tolerability, as compared to more invasive techniques.

University Foot & Ankle Institute podiatrists performs the procedure in the office under local anesthesia using ultrasound guidance.

Platelets are basic cells in our bodies that produce special proteins called growth factors. These growth factors are responsible for healing damage to tissues and wounds and clotting. When there is an injury to part of the body the platelets will rush to the area of injury to begin the healing process. This is part of what is called inflammation. This is true for a new or what is called acute injury. In cases of long standing injury or chronic injury, there is less inflammation and a low concentration of platelets around the site of injury. In effect, the injury is not being aided by healing factors because it is now an old injury.

The idea behind injections of platelet-rich-plasma is to purposefully introduce an increased concentration of the patient’s own platelets into the site of injury. Once there are more platelets around the area, there are then more healing factors in the area, creating an environment that can promote healing. Additionally, the simple act of the needle being introduced several times into the site of injury will stimulate and injure the tissue. The body will think this area is now a new injury. Effectively we are taking and old chronic injury and changing it to a new acute injury, while at the same time introducing even more platelets.

The process of acquiring the platelets is simple. Blood is drawn from the patient’s arm, in the same way one gives blood at the family doctor’s office. The patient’s blood is then spun down in a centrifuge in order to separate the platelets from the rest of the cells in the blood. The high concentration of platelets is now collected in a syringe ready to be injected into the site of injury.

Those patients that have failed conservative therapies are good candidates for platelet-rich-plasma injections. Platelet-rich-plasma as proven to be an extremely effective none surgical form of heel pain treatment.

These injections are a midway approach to help heal chronic plantar fasciitis between conservative care and surgery.

For more information see a published article at http://www.podiatrytoday.com/platelet-rich-plasma-can-it-have-impact-plantar-fasciitis

University Foot and Ankle Institute podiatrists are available for consultation at Santa Monica and Beverly Hills locations of the University Foot and Ankle Institute. For an appointment, please call University Foot and Ankle Institute toll free at:

877-677-0011