Diabetes and Cellulitis

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Image Credit: WebMD 

Your health is what you make of it. Everything you do and think either adds to the vitality, energy and spirit you possess or takes away from it.”-  Ann Wigmore

What is cellulitis?

Diabetes is just a word, not a sentence to a miserable life. While the treatment can be potentially dangerous, as a patient, you can actually look at it as a means to improve your ability to take care of yourself. Studies have shown that stress induces illness, so if you put yourself in a situation where you reverse the root causes of your conditions, you will heal. The interesting thing about diabetes is that it induces various downstream conditions, and with the suppressed immune system can make the body prone to attack by viruses and bacteria. One such condition that the diabetic can be prone to is cellulitis. 

As a painful bacterial skin infection, cellulitis appears as a flash of red on the skin. The picture above depicts the initial phases, of the condition. If untreated, the area can actually become infected and develop into a sore. The underlying tissues of the skin, lymph nodes and the bloodstream can be affected by the condition. 

What are the symptoms of cellulitis? 

  1. Redness of the skin

  2. Warm, tender skin

  3. Sore or inflamed skin

  4. Fever

Additional immune related symptoms have been identified. It will be important for doctors to be aware of your symptoms because if not treated, the symptoms can adversely affect the body. Antibiotics are the best therapy for the condition. Proper foot care is critical for the prevention of cellulitis, as the Staphylococcus and Streptococcus bacteria that induce this condition, can enter the skin via cracks in the skin. Interestingly the following are the root causes of cracks in the skin:

  • Cuts - induced by every day living. Ensure that there are no small stones in your shoes for instance, so that the occurence of cuts and bruises can be prevented. By all means, ensure that you are in a position to always have shoes on hand. Don’t go outside barefooted if you’re a diabetic.

  • Bug bites- induced by every day living. Ensure that you protect your skin if its the summer months. As much as socializing can be fun, outdoor activities can make you prone to bites if you’re a diabetic.

  • surgical wounds - induced by treatment of various root causes. Diabetics are particularly prone to neuropathy. Neuropathy can induce conditions such as Charcot foot, which is treatable by surgical solutions. Surgeries induce cuts into the skin, which can be infected.

Foot Treatments as Preventative Care 

There are a few key activities, which will lead to great foot health. As with all things, prevention is better than cure. The following should be part of your pamper routine if you’re a diabetic: 

  1. Daily Foot Inspection: Take good care, and take the time to inspect your feet at one specified time each day. This could be in the evening once you are getting ready for bed. After your shower, you can take the time to check your feet for any bruises, swelling or ingrown toenails that can affect the health of your feet. A great tool to have is a hand held mirror, so that you can see the base of your feet, and the back of your heels. If you still can’t manage, you can use this as an opportunity to have your partner or your children check for you. 

  2. Lukewarm Baths: The more you nurture yourself, the better you’ll feel and the more that you’ll heal. Warmth improves your blood’s circulation. With a daily wash of your feet, with warm water you facilitate the dilation of your blood vessels, and improved circulation of your blood. This facilitates healing. If you so desire, you can add essential oils to your bath and raise the healing properties of the water. Wash your feet with a soft washcloth, and carefully dry them after your bath. Allow them to air dry. 

  3. Moisturize Your Feet: Your feet have skin as their primary cover. Skin loves and needs moisture in order to heal itself. Use a moisturizer such as Eucerin or Vaseline to keep your skin moisturized and minimize the occurrence of dryness or cracking. Air dry your feet to minimize fungal infections. 

  4. Adequate Foot Care: This is the time of your life, where pedicures should be a standard. When you’re cutting your nails, ensure that they are cut straight and filed. Do what you can to minimize the occurrence of ingrown toenails, because the induced cuts can lead to ulcers. If you see a cut or wound, see your doctor. 

  5. Wear Diabetic Socks: With added cushions, these are special socks that will help you to keep the socks clean and dry. When it comes to your footcare, check your shoes carefully to ensure that there is nothing inside them before you wear them. Since such objects can cut the feet, it is critical to ensure that the feet are protected in their shoes. 

  6. Keep Your Feet Clean and Dry: As strange as it may seem, an antiperspirant on your feet will keep them dry. 

This list is by no means exhaustive, but it is a great start to your diabetic foot care. As with all medical conditions, do consult with your orthopaedic surgeon, in order to ensure that you are getting the appropriate care. Your health is your wealth! 

References: 

  1. Diabetes Footcare Guidelines: https://www.foothealthfacts.org/conditions/diabetic-foot-care-guidelines

  2. Cellulitis: https://www.healthline.com/health/cellulitis#vs.-dvt

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Patient Care: IGF1-Hormone LR3

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Image Credits: Google.com 

“Three things in life – your health, your mission, and the people you love. That’s it. “ - Naval Ravikant

What is IGF1- LR3 Growth Hormone? 

As medical innovations advance, there are a series of important inclusions in patient care, which make the applications of minimally invasive processes that much more effective. Welcome to our patient care series. Periodically, we will introduce you to some aspects of your orthopaedic care, that will educate you on the latest and greatest in medical innovation. When it comes to orthopaedic care, the acute cases are normally treated with over the counter treatments or minimally invasive procedures that will enable you to be able to be in and out of the practice within a few hours. 

For more complicated healing procedures, orthopaedic surgeons have introduced some synthetic help, so that the body can help to heal itself. Theoretically, it was identified that certain aspects of the human body are slow healing, and if damaged, will often require some transplants to restore the area. With detailed investigation of healing mechanisms, root causes of healing have been identified, synthesized and subsequently injected into the body as catalysts for the healing process. With much success, protein therapies such as the IGF1 Hormone LR3 have successfully be implemented into medical therapies. 

While many of these therapies are new additions to existing therapies, and may not necessarily be covered by current insurance packages, independent studies have proven that they are indeed effective. Speak to your orthopaedic surgeon if you feel that you’d love to include new innovations into your therapeutic healing processes. Minimally invasive processes that can facilitate your body’s own natural healing may be just what you are seeking for your current orthopaedic condition. 

The IGF1-LR3 is one element of the Insulin-like Growth Factor hormones which are injected into the body for healing enhancement. As an insulin analogue, the peptide has applications in facilitating bone growth, muscle growth and muscle repair. The scientific name for the IGF-LRS is Long arginine 3-IGF-1. The substituted protein chain of arginine is what differentiates this element from other insulin analogues.

IGF1-LR3 as a protein, stimulates the proliferation and survival of cells. For conditions such as diabetes, all the critical elements for growth are therefore enhanced. This includes the growth of muscle, bone and cartilage. The functions of the protein include: 

  1. A higher bioactivity than insulin promoting growth and healing functions in the injected patient. 

  2. Based on the bioengineering of the peptide, IGF1-LR3 has a higher half life than insulin and natural proteins. As a more stable molecule, it is finding increased applications in the medical industry for culturing and research. 

With a myriad of research proteins available on the market, such as: Melanotan II, CJC-1295, Sermorelin, IGF1-LR3 and GHRP-2, determining the application for research or medical purposes can be a challenge. Talk to your orthopaedic surgeon to determine if the healing attributes of this protein can enhance your healing. If you’re a candidate for treatments such as distraction arthroplasty, your joint restoration could be enhanced by the injection of a protein such as IGF1-LR3. 

Alternate Therapies to IGF1-LR3

How does Stem Cell Therapy Heal My Arthritis?

With the advent of ortho-biologics, arthritis treatments with the facilitation of cartilage restoration is now a modern-day possibility. With options ranging from total joint replacement, to distraction arthroplasty, stem cell therapy and growth factors there are a myriad of evolving technologies and minimally invasive methods that can heal the arthritic site.

As a word of caution, many new therapies are not covered by insurance due to their recency, and the fact that the methods are still being approved by various medical bodies globally. In Australia, growth factors are rebated, whereas stem cell therapy is not. Talk to your orthopedic surgeon about this procedure, and find out how the treatments can be financed. Your doctor may have their own payment options so investigate with them how your therapy can be financed. 

How do Stem Cells or Growth Factors Regenerate the Body? 

The stem cell has long been identified as the regenerative life force in our bodies. With their ability to divide and duplicate, as well as generate new and different stem cells that are relevant to a healing site, it is possible to regenerate cartilage cells and even bone cells. This is great news for the arthritic foot. Over time, the joint can wear away, and with the ability to rebuild it naturally, it will save the individual time from having to go through processes like harvesting. 

How are Stem Cells Administered? 

Stem cells are administered either surgically, or via injection into the arthritic joint. Much like the image above, your orthopaedic surgeon will utilize medical imaging in order to identify where on the body, the stem cells are to be administered. Depending on the severity of the injury, either of the two options will be applied. When the stem cells are being administered, your orthopaedic surgeon will more than likely utilize mesenchymal stem cells that have been harvested from the individual's body. 

When To Approach Your Doctor for Stem Cell Therapy

As a patient, it is very useful to be proactive. Many times, doctors will offer you therapies that are standard practice. If you feel that you want to try something new, you can personally push the envelope and ask them about these next generation therapies. As a transition from external treatments, to natural self healing methods, you may save yourself many months and years of pain. As the field embraces this evolving technology, it will be a joint decision between yourself and your doctor that determines how the therapy is progressed. 

References: 

  1. IGF Hormone LR3: https://www.peprotech.com/en/recombinant-human-igf-i-lr3

  2. IGF Hormone LR3: https://en.wikipedia.org/wiki/IGF-1_LR3

  3. IGF1 and IGF3 Comparison: https://www.bioprocessonline.com/doc/igf-long-igf-lr-is-there-difference-us-peptides-discusses-0001

Reference Articles for Stem Cell Therapy: 

1)Cartilage Restoration: http://www.cartilagerestoration.org/stem-cell-ortho-biologics-and-regenerative-medicine-program

2)Stem Cell Therapy for Arthritis: https://www.arthritis-health.com/treatment/injections/stem-cell-therapy-arthritis

3)Regenerative Stem Cell Therapy for Foot and Ankle Pain: https://www.stemcellctr.com/procedures/foot-ankle/


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Arthrodiastasis

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Image Credit: Science Direct 

“Health is the thing that makes you feel that now is the best time of year.” - Franklin P. Adams

Arthritis is statistically one of the most prevalent foot and ankle conditions. As an ailment, it can be quite painful. While various treatments ranging in complexity are utilized in the medical realm, ultimately, the fix to the condition will be a practice that will either restore the joint, or induce the replacement of a part of the hinge joint. With very severe cases of arthritis, surgical treatments are the path to recovery. Individuals with severe cases of arthritis are treated in one of two ways: 

  1. Ankle Arthrodesis

  2. Arthroplasty With Implants 

While every surgical process has its pros and cons, the risk management strategy will be what your orthopaedic surgeon will utilize to determine your best treatment path forward. Minimally invasive surgical procedures do exist, but variables such as age, gender and stage of severity have major impacts on the treatment path. Surgical risks include: 

  1. Infections and Non-Unions in Ankle Arthrodesis

  2. Abnormal gait  due to minimized Ankle Movement

  3. Restricted motion 

Drawbacks of Ankle Arthroplasty include: 

  1. Not all candidates are eligible for joint replacement due to weight restrictions. Past a certain weight point, individuals are exempt from this procedure. 

  2. Joint failure within a twenty year span. Mechanical equipment is not infallible, and often individuals may end up in a situation where their joints are impacted by external pressures and stresses and strains cause the joint to fracture. Under this condition, the joint will have to be replaced with a unit that is working. 

  3. Surgical mistakes can cause additional damage to the patient. Potential surgical injuries during the joint installation include damage to the bones (bone fractures during installation), nerve and tendon, and blood vessel injury. The replacement joint may not always fuse with its new home, and it is necessary for the patient to have an additional surgery to help with the healing process. 

The treatment that is an effective replacement for the aforementioned two treatments for arthritis is ankle arthrodiastasis. With the advent of medical innovation, the treatment has proven itself effective in being an alternate treatment to either fusion treatment or joint replacement. 

How does Ankle Arthrodiastasis Work? 

Arthrodiastasis involves joint separation as a means to induce healing of the area. Evolving since the late nineteen seventies, distraction therapies proved themselves as effective therapies for the treatment of joint pain. Medical studies showed that the use of an Ilizarov frame (see image above) was a means via which the arthritic ankle could simultaneously be allowed to heal, without limiting the mobility of the joint. Fused with such a therapy, is the filling of the joint with various fluids or suspensions such as hyaluronan (a critical molecule in joint restoration), or even stem cells in an appropriate base. Regardless of the path, the aim is to restore the cartilage surfaces of a joint. Once cartilage is restored, the smooth operation of the joint will be achieved. 

Ankle Arthrodiastasis Research

From our second article reference, a total of 65 ankles were assessed for their performance after the ankle arthrodiastasis procedure was completed. The patients under study, included moderate to severe arthritis with symptoms including pain and limited range of motion. Patient age was ranging from 42.5 years to 62 years in range. The following were the patient statistics: 

  1. 41 male patients and 22 female patients 

  2. Diagnoses: Osteoarthritis(68%), Post Traumatic Arthritis (21%), Charcot Arthropathy (8%), Adult Residual Clubfoot (3%). 

The outcome of the surgical procedure was favorable, with no deep infections developing as is potential for the two alternate therapies. Of the patient pool: 

  1. Two had to revert to arthodesis due to increase in pain after 12 months. 

  2. Superficial pin site infections in eleven patients (treated by antibiotics and improved hygiene)

  3. Ligamentous laxity and instability (four patients) , treated by physical therapy and braces 

  4. Edema in six patients.

  5. Superficial necrosis in two patients (treated by wound care therapies) 

The balance of the patient pool had a normal recovery, and were able to resume their normal life activities after their complete healing.

How does arthrodiastasis of the ankle work? 

Using a series of mechanically manipulated braces, the joint is gently re-aligned via the process of mechanical unloading it and transferring the weight to the external metal scaffold. With many foot and ankle surgeons utilizing this procedure, feel free to consult with your specialist, to find out if this process will be suitable for you to utilize in your therapy. 

Ankle arthritis can be developed from various root causes, inclusive of athletics. Athletics is physically intensive, causing excessive use of the ankle joint which can result in wearing away of the joint, via degradation of the articular cartilage in the area. Utilization of the external fixator to hold the ankle in place, while healing is facilitated will be an ideal therapy. Arthritis symptoms include:

*Pain and Stiffness in the Joint 

*Wearing away of the articular cartilage

* Hardening of the surrounding bone

*Damage to the cartilage cells 

When installed, the arthrodiastasis apparatus facilitates the joint restoration, holding the joint in place, and enabling the cartilage cells to restore. While the joint itself is active, the area has minimal time to heal. The fixator, via gently pulling the joint apart, enables the body to naturally heal itself due to the additional physical support. 

Via a series of pins and wires, the external fixator is attached to the leg. The pins are attached to the bones of the ankle, and connected to the external scaffolding via the wires, and finally are connected to the external rings. The external hinge mechanism facilitates ankle mobility. With the fixator in place, the brace is in place for approximately 10-12 weeks. 

Consult with your foot and ankle surgeon today, to find out if this procedure will be ideal for your arthritis condition. For mild cases, alternate therapies might suffice, but if you feel that you are in a severe case, arthrodiastasis of the ankle will be a treatment that could facilitate healing and restoration. 

Reference Articles

  1. Ankle Distraction: https://www.hss.edu/conditions_ankle-distraction-arthroplasty.asp

  2. A New Solution For the Arthritic Ankle: https://www.podiatrytoday.com/article/4898

  3. Pros and Cons of Ankle Arthroplasty: https://healthresearchfunding.org/12-pros-and-cons-of-ankle-arthroplasty/

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Joint Distraction Surgery

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Image Credit: Journal of Orthopaedic Surgery and Research - BioMed Central 

“Health is a large word. It embraces not the body only, but the mind and spirit as well; …and not today’s pain or pleasure alone, but the whole being and outlook of a man.”- James H. West

Arthritis, is statistically one of the most prevalent joint conditions. With the advent of medical innovation, the industrial trend is to facilitate the repair of joints, as an alternative to joint replacement in the advent of advanced cases of the health condition. Traditionally, it was found that regions of the body that were affected severely by arthritis were treated by joint replacement surgery. While studies showed that joint replacement was effective on regions of the body such as the knees and hips, the osteoarthritic ankle is a special breed. 

The ankle is sensitive to therapies because of its location, and weight bearing capacity. In the case of ankle treatments, medical research has determined that the best therapies for joint restoration include the utilization of scaffolding technologies such as joint distraction arthroplasty. While lasting longer in terms of healing than joint replacement, the ultimate restoration of joint health is maintained in the long run. 

Alternative Healing Therapies for Osteoarthritis

While acute treatments of arthritis involve therapies such as the use of mild pain relievers, insoles and ankle wraps, it is possible to utilize surgical treatments for the more advanced cases. Traditional methods of healing osteoarthritis include the process of fusion or arthrodesis. These methods facilitate internal scaffolding in order to improve joint integrity. 

With an interconnected network of plates, and screws, the joint internal support is vastly improved and the ankle and leg are permanently affixed via this external support. The benefits of the procedure favor pain relief, but they are not aesthetically pleasing. 

Joint Distraction Arthroplasty

While both fusion and joint replacement have their pros and cons, it was identified that joint distraction surgery, via the procedure of joint distraction arthroplasty is an effective method of facilitating the body’s natural mechanisms in order to allow the joint to heal naturally. As indicated in the progressive X-rays highlighted in the image above, distraction arthroplasty involves: 

How does the Distraction Arthroplasty Procedure Work? 

Arthritis as a condition, involves the degradation of the articular cartilage that facilitates smooth joint operation. When your orthopaedic surgeon assesses your X-rays there will be cartilage loss that can easily be seen. As the joint stiffens, the patient will feel pain which affects their mobility. Since the joints are constantly in motion, healing is always slower than anticipated. By utilizing distraction arthroplasty, the body will be allowed to naturally heal itself. The procedure serves to release the joint contact, and the inter-bone spaces where the cartilage occupies is allowed to regenerate as there is renewed blood circulation to the area. What circulation does is facilitate healing. 

How is the Joint Distraction Arthroplasty Surgery Conducted? 

The distraction arthroplasty procedure is categorized as minimally invasive. A frame is erected around the joint to be treated. Via a configuration of rings, plates, hinges and screws as you’ll be able to see outlined in the image above, the ankle and leg are gently cradled. The application is executed surgically, and the removal is accomplished in a similar way. During surgery, if there are any additional joint adjustments to be made, they will be facilitated by your surgeon. If there are any bone spurs due to the joints rubbing together, they will be removed. Additionally, techniques to facilitate cartilage repair will be facilitated by your orthopaedic surgeon. 

Healing Therapies

Medical Innovation is a process that is continuously evolving. During the healing process, mesenchymal stem cells from the patient's bone marrow injected to the area. They jumpstart the healing process. Stem cells have the ability to adapt to their environment, and as a result they are able to morph into cartilage cells that will adhere to the bone surfaces and facilitate smooth joint restoration. In the past, scar cartilage was engineered by the surgeon via scraping the existing cartilage from the bones and allowing it to regenerate on its own. Scar cartilage is weaker than original cartilage, so it advantageous to utilize stem cells to help with the healing process. Embedded in a fibrin matrix, the cells are able to integrate with their environment and adapt to their new conditions. 

Post Operative Care

The Distraction Arthroplasty process takes about two days. The first day is to facilitate the surgery, and the second day is to ensure that the patient can confidently manage to operate with the frame. A physical therapy session is usually prescribed, after which, the patient is discharged and allowed to return to their home life to heal. The frame is worn by the patient for ten weeks. They will be allowed to participate in regular hygiene activities such as showers, and also swim in pools. Careful treatment of the area where the skin is penetrated by the frame is also prescribed by the orthopaedic surgeon. 

Research Credits: 

  1. Joint Distraction Surgery: https://www.hss.edu/newsroom_joint-distraction-surgery-knee-ankle-osteoarthritis.asp

  2. Functional Analysis of Distraction Arthroplasty: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5270240/

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Post-Operative Pain Management in Orthopaedic Surgery

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Image Credits: Cleveland Clinic 

In some severe cases, it will actually be important to have surgery as a means to correct your underlying ailments. In the orthopaedic field, there are millions of surgeries that are performed. With each surgery, there is a need for post operative care. Termed formally as “Acute Post-Operative Pain Management” strategies, studies have indicated that the pain levels of orthopaedic surgeries are actually on the higher end of the scale. Statistically, on the orthopaedic scale, 86% of patients identify their pain to be on the moderate to extreme scale. 

Patient care is therefore one of the key contributors to the choice of orthopaedic surgeon. The patient needs to feel assured that they will be in good hands. Since surgery carries with it more than just the physical experience, the patients do experience mental stresses as well that can affect their ability to fully heal once the surgery has concluded. Patients fear pain to the point where some will actually delay their surgery until the last minute due to their apprehension, it is therefore important to have an appropriate plan in place that will alleviate the condition when it arises. 

As the field of medicine evolves, postoperative care is becoming a primary area of concern in the orthopaedic field. The key to successfully managing the pain is have a plan that will facilitate the healing process. During the process, key personnel such as the orthopaedic surgeon, nurses and anaesthesiologists will be on hand to facilitate the pain plan that will enhance patient healing and recovery at a much faster pace. 

Surgical care has identified the following as ideal optimization points for a patient: 

  1. Optimizing pain control for the individual patient both during and after surgery.

  2. Ensuring safety both during and after surgery.

  3. Minimizing post surgical side effects.

  4. Maintaining ease of use for staff and patients. The majority of pain management actually takes place at home, post surgery so plans are in place during the hospital visit to ensure that the patients and their givers are well versed with respect to the care plan.

  5. Reducing complications is critical with time. All medical procedures have risks and it will be important to factor in the criteria such as gender and age before the surgery itself is actually attempted.

Establishing a Good Relationship With your Orthopaedic Surgeon

Your orthopaedic surgeon is there to provide you with a service as you traverse your healing journey. A good relationship with your doctor will ensure that the healing process proceeds much faster. With improved confidence in the doctor, and the prescribed plan, patients can actually anticipate what will happen in a more realistic fashion. Appeasing the fears of the patients will ensure a much smoother recovery. With your surgeon, you will identify your ideal plan, and as a result be in a position to ensure that the patient is not in a state where they are resuming activities prior to the stated healing time. 

Patient and Caregiver Education

Knowledge is always power. Since a team of individuals will be the ones who will be treating the patient, it is a good idea for the patient and their caregivers to get to know the nursing staff at their treatment facility. The team will go through the patient's medical history, and collecting help with the healing process. In the instance that the doctor is not immediately available, the nursing staff will be the individuals who will be able to facilitate the healing process. They are the ideal individuals to get to know, as the process unfolds. 

Drug Management 

With orthopaedic surgeries ranking high for pain threshold, ensure that you and your doctor carve out a plan for appropriate therapies such as drugs during your healing process. The anesthetist on your treatment team, is also actively involved in post operative pain management, and will ensure that you are in a comfortable state. When the surgery is  completed, you may have a series of either over the counter drugs such as pain relievers and antibiotics to take in order to ensure that you are controlling post-operative infections and reducing your fever so that you can heal. 

Your health is your wealth, so take the time to ensure that your surgical process is as smooth as possible. Ensure that you are in the process of maximizing your knowledge of what you are to know, and then taking the appropriate action. 

Resource: 

  1. Medscape: https://www.medscape.org/viewarticle/556201

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Cartilage Regeneration Via Morphoangiogenesis

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Image Credits: Springer

What is Morphangiogenesis?

The science of angiogenesis, is the process of creating new blood vessels from pre-existing units. The vessels are formed during the process of vasculogenesis, and the angiogenesis process facilitates the growth of the vessels via a series of biological mechanisms. As with all scientific processes, there is always an evolution of the angiogenesis process. 

Developed by the American orthopaedic surgeon, Dr Allan Dunn a new method of inducing angiogenesis was developed in the past decade. The process is known as morphoangiogenesis (M-A). The technology is based on the utilization of stem cells, with the process facilitating two streams of stem cells. When a site is injected with IAGH,  a growth hormone, two structures are developed. One resembles cartilage canals, the other is similar to renal glomeruli. The growth rates of these structures vary, but they produce units with capillaries that can develop into articular cartilage. 

What are the applications of Morphoangiogenesis? 

There are some parts of the body that take a long time to restore if they are damaged. These include the cartilage in the various joints in the body, particularly in the knees, ankles and elbows. During therapy of these areas, medical innovation has facilitated the utilization of growth hormones such as IAGH to help restore joints. From the above discussion, it was identified that IAGH facilitates rejuvenation because it helps to regrow the cartilage. 

With medical procedures in place that typically will remove existing cartilage, and allow the growth of a scar tissue called Fibrocartilage, IAGH facilitates the regeneration of the originally tissue. Fibrocartilage is weaker than its original cartilage, so it is in the best interest of both the physician and the patient to restore the healthier tissue. For persons with arthritis, cartilage regeneration is an option that your orthopaedic surgeon will consider during your arthritis treatment. 

From the website of Dr Dunn, the following are some frequently asked questions that patients may have about cartilage regeneration via IAGH induced Morphoangiogenesis: 

  1. “What is the success rate of IAGH treatment?
    Based on significant measurable increase in motion, decrease of pain, and increase of joint space, the following percentages give some idea of the success rate:

    • Ankles 95%

    • Knees 86%

    • Hips 50%

    • Elbows 95%

    • Shoulders 75%

    • Thumbs 75%

  2. What are the beneficial effects of IAGH treatment?
    Decrease or complete abatement of pain, swelling, heat and stiffness in the treated joint. Measurable increase in the space between the bone surfaces. The bone on bone condition often improves and space re-appears - up to a 4 millimeters between the bones. Several patients have been followed over five (5) years, and their symptoms have not recurred. In several cases of osteoarthritis of the knee, the bow-legged deformity was reversed and the alignment of their knees WAS restored to normal.

  3. Do you need to continue receiving IAGH injections?
    Some patients require booster injections of IAGH ONCE A YEAR OR ONCE EVERY 2 YEARS.

  4. What are the side effects of the IAGH treatment?
    There were a few side effects and they were mild and reversible. There has RARELY been pain or swelling at the injection site.
    TOTAL JOINT SURGERY CAN HAVE SERIOUS COMPLICATIONS SUCH AS INFECTIONS, DEEP VEIN THROMBOSIS, PULMONARY EMBOLISM, and DEATHS.”

DISTRACTION ARTHROPLASTY AS AN ALTERNATE ARTHRITIS TREATMENT

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Image Credit: hss.edu

Ankle arthritis is a condition that is prevalent in young, active individuals predominantly. Via excessive usage of the joint, wear and tear can be induced, causing the joint to weaken. Because the healing ability of the body is slower than that of many animals, intervention has to be induced in order to facilitate the appropriate conditions that will enable change. The procedure that enables the ankle joints to heal in a natural fashion over a period of months is known as distraction arthroplasty. 

As a procedure that requires surgical intervention, ask your foot and ankle surgeon about this procedure if you feel that it will be appropriate for your condition. Your consultation will involve a series of tests, inclusive of X-rays, to identify the state of degradation of the ankle joint. If you suffer from mild arthritis, distraction arthroplasty may not be ideal for you, but more advanced cases are ideal candidates for the procedure. Via a series of mechanical braces, the stresses experienced by the ankle joint are alleviated, and the cells in the region are given a chance to regenerate themselves and restore the joint to its former capabilities. 

Mechanism of Action 

The mechanism of action of distraction arthroplasty, is to unload the ankle. The ankle as a hinge joint, is an amazing biological engineering marvel. As a weight-bearing joint, the ankle is designed to withstand up to 5.5 times the body weight of an individual. Along with the stout ligaments, the steady control of the region is maintained. With time and activity, slight changes in alignment of the ankle (talus displacement) can generate up to a 42% decrease in available joint contact area. With such changes, the cartilage that is exposed will experience higher compressive forces at pressures that it was not originally designed for, and it will ultimately degenerate. The distraction arthroplasty treatment is a series of mechanical braces that aims to restore the original alignment of the bones in the ankle, and facilitate a restoration of the cartilage. 

Unloading the ankle, relieves it of the external pressures and allows natural healing. With reduced pressure and more blood circulation to the area, healing will be facilitated. Alternate therapies for arthritis include fusions and complete ankle replacements. Consultations with your orthopaedic surgeon will determine the path that is best for you. With the external fixator adjoined to the bones via series of pins and hinges, the ankle is allowed the following in a combination with adjunct surgeries: 

*Stability

*Range of Motion - patients will be mobile during their treatment and can bear their full weight

*Cartilage Repair 

*Exercise of the area will be permitted in order to facilitate motion, and joint repair. 

In order to facilitate the attachment of the fixator, your orthopaedic surgeon will perform two procedures. The first is a surgery, that facilitates the installation of the frame to the tibia (leg bone) and finally to the foot. You can envision the frame as an external scaffold around the critical areas that need healing. Via a series of fused wires and pins, the frame is built. With an attached hinge, the required motion is facilitated. If necessary, your orthopaedic surgeon will conduct further ankle joint modifications that will facilitate healing. If ligaments need to be loosened, this procedure will also be facilitated. 

How long is the Distraction Arthroplasty Treatment? 

The distraction arthroplasty treatment lasts for ten to twelve weeks, or approximately three months. Via a second procedure, your orthopaedic surgeon will remove the external fixator, and apply a cast to hold the foot in place.  

Reference Articles for Distraction Arthroplasty: 

  1. http://legacy.aofas.org/footcaremd/treatments/Pages/Distraction-Arthroplasty.aspx

  2. https://www.hss.edu/files/Ankle-Distraction-Arthroplasty-Indications-Techniques-Outcomes.pdf

Reference Articles for Morphoangiogenesis: 

  1. Morphoangiogenesis: https://www.ncbi.nlm.nih.gov/m/pubmed/11969306/

  2. IAGH Mechanism: http://www.iagh.com/

  3. Angiogenesis: https://en.wikipedia.org/wiki/Angiogenesis


Cheilectomy To Treat MTP Joint Arthritis

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Image Credits: Footfiles 

What is the MTP Joint? 

The metatarsophalageal joints (MTP joints), are identified as the connection points between the phalanges (toe bones) and the metatarsal bones in the feet. Physical stresses can cause the joint alignment to shift, and induce ailments such as joint arthritis. There are five MTP joints on each foot, and in orthopaedics the “MTP Joint” is the term referring to the big toe joint, since it is the site primarily affected. The main MTP joint is critical to balance, and care must be taken in the instance of pain experienced in the area. When aggravated enough, the cartilage in the MTP joint can wear away, and generate bone spurs and joint arthritis. Acute therapy for MTP joint arthritis includes physical therapy. For severe conditions, surgery will be needed. This article will focus on the therapy known as a cheilectomy. 

What is a Cheilectomy? 

The cheilectomy procedure incorporates various steps in order to facilitate the restoration of the joint. Generated bone spurs are one of the primary objectives of the procedure. During arthritis, these bone spurs develop on the top of the big toe, creating a protrusion. When this occurs, there is a swelling of the joint, and the patient will experience pain in the region, and limited mobility. As a minimally invasive procedure, the cheilectomy will ensure that big toe mobility is restored. 

What Symptoms Do Patients Experience During MTP Joint Arthritis? 

MTP Joint Arthritis symptoms include: 

  1. Stiffness in the joint. Toes are designed to be flexed and pointed, and with joint arthritis, accomplishing this action will be difficult for the patient. 

  2. Pain induced by the stiffness of the joint and the presence of the bone spurs

  3. Cartilage Loss resulting in a minimized ability of the joint bones to smoothly coordinate during motion. The cartilage will change from a healthy thick white film to a yellow thin film. 

  4. Benign Bone Cysts that can develop in the periphery of the joint surface. 

Cheilectomy Surgery

Your surgeon will determine if you are a candidate, based on the severity of your condition. The more symptoms experienced is the higher the likelihood of you being a surgery candidate. The surgical steps involved in a cheilectomy may include elements of the following:

1.Arthroscopy of the mtp joint

2.synovectomy

3.debridement

4 minimally invasive correction of the great toe angle and insertion of screw

5.minimally invasive removal of bone spurs

With the procedure, the differing elements described above will facilitate the removal of the bone spurs. Mini-incisions are used with a specialized reamer tool to remove the bone spurs. A mini screw maybe inserted if correction of the great toe is required. These are closed with steri-strips.

Post Surgery Recovery Process

As a minimally invasive procedure, the procedure is completed under anaesthetic in less than one hour. Patients can return home on the same day, and can walk after surgery. Your surgeon will book your post-operation visit for your suture removal approximately two weeks after your procedure is completed. 

As a therapy that is quite effective, joint motion can be improved quickly. Talk to your orthopaedic surgeon today, if you feel that this minimally invasive procedure will be suitable for your MTP joint arthritis. 

Reference Article: 

  1. What Is A Chielectomy? : https://www.verywellhealth.com/cheilectomy-surgery-faq-1337652

  2. Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406985/

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MTP Joint Arthritis

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Image Credits: mortonsneuroma.com

“Health is a large word. It embraces not the body only, but the mind and spirit as well; …and not today’s pain or pleasure alone, but the whole being and outlook of a man.” - James H. West

From the anatomy of the feet image that is shown above, the metatarsophalageal joints (MTP joints), are identified as the connection points between the phalanges (toe bones) and the metatarsal bones in the feet. If you imagine your feet as a mechanical system, the addition of enough stress and strain induced by either sporting activity or daily life, can result in the joint alignment being shift. The result of the MTP joint misalignment is that the joint cartilage and lining can both be damaged, resulting in a painful sensation and also in the severe cases - joint arthritis. 

With five MTP joints on each foot, technically, the “MTP Joint” is the term referring to the big toe joint. There are three main pain points in the MTP therapy, and this site is the most prevalent. The main MTP joint is critical to balance, and care must be taken in the instance of pain experienced in the area. 

Statistics have shown that arthritis in the feet, is a condition that plagues adults over the age of 50. One of the areas of the feet affected by joint arthritis include symptomatic radiographic foot osteoarthritis, which affects approximately 17% of the adult sufferers in the defined category. The regions of the feet affected by this condition include: 

  1. The First Metatarsophalangeal Joint

  2.  The Second Cuneometatarsal and Talonavicular joints

Treatments of the aforementioned conditions are variable, with a range of therapies from physical therapy, foot inserts and surgery in the adverse case.

Background

As an illness, osteoarthritis (OA) is a leading cause of disability in the aging population, with 10% of people aged over 60 years being diagnosed with this condition. With time, this debilitating condition can degenerate and lead to the following life changes in an individual: 

  1. Reduction in Locomotor Function. Mobility is affected. 

  2. Social Impact, due to reduction in ability to participate in physical activity

  3. Economic productivity due to limited mobility 

  4. Poor Balance 

  5. Risk of Falling 

  6. Increase in Medical Visits 

With statistics indicating that one in ten people over the age of 70 will be developing foot conditions, there is a need to improve the awareness of foot care. As scientific studies increase, it will be possible to classify foot conditions faster, and improve their treatment rates. Technologies such as a radiographic atlas, and grading system, are helping to facilitate appropriate root cause analysis. Since various factors such as gout, osteoarthritis, rheumatoid arthritis, psoriatic arthritis and septic arthritis can influence the same final symptoms, it will be critical to determine the course of treatment according to the source. 

How is MTP Joint Arthritis Treated? 

The treatment of arthritis is a case by case analysis, that is dependent on severity. In the early stages the following treatments can be utilized: 

  1. Conservative interventions, including analgesic or anti-inflammatory medications

  2.  Intra-articular injections

  3. Physical therapy 

  4. Footwear modifications

  5.  Foot orthoses

If the need escalates, then surgery is considered. With respect to the surgical procedure, you will consult with your orthopaedic surgeon in order to determine the best surgical treatment path for yourself. Conservative treatments appear to work for the majority of patients. Drug therapies such as the use of Oral non-steroidal anti-inflammatory drugs (NSAIDs) have been found to be effective. Treatments such as piroxicam and naproxen were found to provide successful therapeutic impacts in patients who were placed on these treatments. 

Surgical Interventions

MTP joint surgery is a last resort treatment, for patients with adverse arthritis in the joint. Patient treatments are via three treatment streams: cheilectomy for joint preservation, implant arthroplasty and arthrodesis for joint restoration. 

As with all treatments, consult with your orthopaedic surgeon for the best path forward. Your health is your wealth. 

Reference Articles: 

  1. Types of MTP Joint Problems: https://www.healthline.com/health/mtp-joint

  2. Foot osteoarthritis: latest evidence and developments: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871064/

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Post-Operative Care

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Image Credit: https://www.homecare-vancouver.com/

POST-OPERATIVE CARE 

Depending on your foot and ankle condition, your orthopaedic surgeon may prescribe you a surgical treatment. The treatment process involves a series of action steps that you and your doctor will undergo, in order to ensure that your healing is at its optimum. 

Ideally, you’ll undergo an examination that will identify your condition. Depending on the severity of the condition, you’ll be prescribed a surgery. After surgery, there is a healing period. Depending on your procedure, healing time may range from a few weeks, to a few months of extensive treatment. 

This article will focus on the healing process for a Total Ankle Replacement. This procedure is one of the more extensive services that your orthopaedic surgeon may perform. Once a surgery is performed, the treatment process is actually taken in stages. 

Stage 1: Limited mobility for the first two weeks after surgery to facilitate wound healing after incision. For six weeks a surgical boot or splint will be worn by the patient to assist with mobility. 

Stage 2: This stage of the journey involves restoration of mobility. Towards the latter period of the healing process, physical therapy sessions will be incorporated into the treatment to facilitate full healing and mobility. Overall healing will vary according to age and health, and the factors and time frames will be discussed with your orthopaedic surgeon.

AT HOME POST SURGICAL CARE

Once the surgery is completed, the next phases of the process involve at home care. Before the surgery, your orthopaedic surgeon will let you know what items you’ll need to have on hand to ensure that you have the optimum care at home. Limit your driving during the healing process, and arrange for someone to drive you to any critical activities such as for doctor visits and physical therapy. Ideally, you will have purchased these items before you actually have the surgery performed. This will save you from having to gather items post the surgery. Life is easier when you are prepared. 

The surgical procedure requires you to ensure that the following are in place, in order to simulate the hospital environment. With limited mobility, it will be key to ensure that as a patient, there is ready access to amenities such as: 

  1. Kitchen: Since mobility will be limited, it will be ideal for you to be in a bedroom near to your kitchen. If your home is split level, if your meals can be brought to you by your spouse or children, that can also help to keep the feet still so that you can heal. 

  2. Restroom: If you have an ensuite, this is ideal since the bathroom will be a few steps away from your bed. 

ITEMS YOU’LL NEED FOR POST SURGICAL CARE

  1. Anti-inflammatory Treatments: The healing process takes time, and there are a few things that you can do to facilitate the healing of your ankle. Post surgery, there may be some minor swelling, which you can treat at home with some prescribed treatments or anti-inflammatories such as Tylenol or Advil. 

  2. A Foot rest or Pillows to elevate the feet above the heart while you are resting. 

  3. Crutches, Boots  or Splints for Mobility: These are critical for weight management after surgery. 

As with all healing processes, the healing times will vary, but your doctor will ensure that you have the appropriate healing plan. Your health is your wealth. If the post operative care is as outlined, you’ll be well on your way to a full life after completion. To your health! 

Reference: 

  1. Rothman Orthopaedic Institute: https://rothmanortho.com/stories/news-and-blog/how-to-prepare-for-recovery-time-for-total-ankle-replacement

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BioCartilage Treatment of Osteochondral Lesions

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Image Credits: WQAD.com 

What Is BioCartilage? 

When it comes to your health, and life in general, it is always important to think thoughts that are cutting edge, innovative and revolutionary. In the orthopaedic world, BioCartilage is emerging as a technology that can heal your arthritis, and enable healthier joints and more longevity. BioCartilage as a therapy has facilitated the restoration of the osteochondral lesion (located in the ankle joint) via minimally invasive therapies. The healing properties of BioCartilage are proving to induce faster healing, and more permanent healing. 

BioCartilage as a treatment for cartilage restoration, is derived from donor cartilage, and fused with natural growth factors to help stimulate the healing of cartilage cells. 

How is BioCartilage Applied to Heal The Ankle Joint? 

Applying the ankle image above as a baseline, one can visualize that the ankle joint is comprised of two main bones - the tibia and the talus. The tibia is the large vertical bone, and it is resting on the horizontally orientated talus bone. Joint fusions need lubrication much like mechanical joints in physical systems. This lubrication is provided by cartilage, which is a tough tissue that is directly on the bone. 

There are instances where the cartilage can wear away, and expose the bone. In this instance, the bones can rub against each other causing a very painful experience. The wearing away of cartilage generates what is known as an Osteochondral lesion. They are usually induced by sports or life induced sprains.  BioCartilage is a means via which the smooth bone cartilage interface can be restored. 

Osteochondral Lesion Treatment

Traditional surgical treatments involved complete removal of damaged cartilage, and the facilitation of the regrowth of fibrocartilage (which acts like scar cartilage), and additional support by a cartilage plug. The procedure, although helpful, did not completely heal the area. BioCartilage has proven to be more effective than this traditional treatment because it actually creates a 3-D micro-scaffold to allow regrowth of the original cartilage. 

Once surgically installed into the ankle region, the healing time is as follows: 

  1. Two to four weeks of in cast healing 

  2. Physical Therapy after week four 

  3. Weight bearing after six weeks of treatments

As with all treatments, talk to your orthopaedic surgeon if this therapy is one that you’ll feel will help to heal your arthritis. Your orthopaedic surgeon will assess your foot and ankle with tools such as an X-ray or an MRI scan. 

Reference Articles: 

  1. BioCartilage: https://journals.sagepub.com/doi/abs/10.1177/2473011418S00049

  2. BioCartilage: https://www.footankleinstitute.com/treatments/biocartilage-for-osteochondral-lesion


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Managing a Stone Bruise

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Image Credit: https://www.joionline.net/trending/content/what-stone-bruise

"Exercise itself, which tends to be highly repetitive when engaged in regularly, is a major driver of neuroplastic changes in the brain, which is why physical exercise is one of the most important factors in restoring and maintaining mental as well as physical health across the life span, starting from the moment one begins such a program." - Bob Stahl, A Mindfulness-Based Stress Reduction Workbook 

Metatarsalgia is the scientific name for what the lay man knows as a “Stone Bruise”. Caused by a swelling of the metatarsal head, that is located at the base of the feet, the ailment is quite painful to the patient. With a stone bruise, there is usually tenderness. The area doesn’t look like a typical bruise, because there is often no discoloration in the affected regions of the feet. The ball of the feet will be sensitive to any activity of the feet. 

What Are the Causes of A Stone Bruise? 

When an individual applies impact to the foot via a sudden change or heavy impact to the feet, a stone bruise can be induced. The impact can be induced by having the feet suddenly impact a hard surface such as the ground, concrete or a tiled area during physical activity. Running and jumping on hard surfaces is the key cause of a Stone Bruise. Additionally, if you’re affected by the following: 

  1. Being over-weight or suffering from obesity: This condition will impact your gait, and with a heavier body, it is possible to impact the ground harder than if your weight was as your body was designed. 

  2. Stress Fractures 

  3. Age: With maturity, the bones can weaken if appropriate nutritional changes aren’t made. Impacts to the feet can result in injury much more easily. 

  4. Pre-existing medical conditions such as bunions, rheumatoid arthritis, diabetes and Morton’s neuroma can induce a stone bruise. 

What are the Symptoms of a Stone Bruise? 

The initial symptoms of a Stone Bruise are the indications that the ball of the foot is tender. When a patient goes through the process of flexing the toes and feels pain in the capsule and soft tissue at the base of the joint, it is possible that you have a Stone Bruise. Consult with your orthopaedic surgeon in order to confirm your condition. If you’re prone to a structural problem in your feet, the odds of a Stone Bruise are highly increased. 

When you consult with your doctor, ensure that these factors are identified as the consultation is taking place. Your treatment will be heavily dependent on your body’s design. 

What Are The Treatments for a Stone Bruise? 

Stone Bruises are readily treatable either at home, or via the help of your foot and ankle specialist. The condition, is painfully, but on a severity scale they are considered minor conditions. With the pain ranging from mild to severe, and with associated tingling, there is the possibility of allowing the feet to naturally heal. The first few action steps that you can take include:

  1. Limiting activity on the affected foot. Rest is critical to the healing of your feet. When you have bruises that develop, it best to keep the foot elevated or with minimal weight on the leg, so that the healing process can be facilitated. 

  2. Application of anti-inflammatory tools. These can include application of ice to the area, to soothe the area. Coupled with an anti-inflammatory treatment, ice will facilitate the healing of the sensitive, enflamed area. 

  3. Cushioning the area, with a metatarsal pad is also useful in the healing of your Stone Bruise. If you’re an athlete, in your shoes, you can place insoles that will heal the area. 

Watch your condition, and with time, you can heal yourself. If your condition isn’t improving, ensure that you consult with your orthopaedic surgeon. 

Reference Article: 

  1. What is a Stone Bruise: https://www.joionline.net/trending/content/what-stone-bruise

  2. What is a Stone Bruise: http://www.aapsm.org/stone-bruise.html

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Foot Spa Essentials

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Image Credits: RelaxThoseFeet.com

There is a medical adage that states “Prevention Is Better Than Cure”. Truer words have never been spoken. When it comes to our feet, they are one of the most neglected aspects of our bodies. The only time most of us remember that they exist is at the point where arthritis starts to set in, or the point at which we sprain the ankle and need to keep it wrapped so it can heal. While the world isn’t expecting you to be high maintenance, it is helpful to pay at least ten minutes to half an hour of attention to your feet before any serious complications develop. 

With our daily lives, physical activity such as walking or running can place a toll on our feet. Depending on the impact, it is often important for one to revamp the feet once a workout or daily activity has concluded. With the summer/winter, how does one actually manage to take care of the feet? 

As a start, you can consult with your orthopaedic surgeon to identify what possible items will be beneficial to your at home pamper kit. This is a great option, if you’re diabetic, and need to attend to your feet regularly. Instead of self-care feeling like a chore, it will feel like a luxury and you’ll want to do it. If you can, indulge in the following: 

  1. A Foot Spa: With a wide range of options from the super affordable to the super luxe, it is possible to purchase for yourself an at home foot massager. With this massager, you can facilitate the massaging of your feet, and improve the circulation through your entire feet and ankles. The soothing warm water will relax both your feet and your mind. Interestingly, if you really want to go low budget, you can add some dish washing liquid to your water. The agent is antimicrobial and moisturizing. Additionally, you can purchase foot soaks from your local pharmacy or beauty supply store. Jazz up the experience with a little lavender soak, and you’ll be healing and relaxing at the same time. 

  2. Epsom Salts: The versatility of Epsom Salts cannot be stated enough. From an internal perspective, it is the perfect body detox for your liver. If you ever feel your energy levels on a low, it may be that your body is toxic. Toxicity is induced by the ingestion of preservatives with time. You can either detox via internal ingestion of the salts, or you can detox via the osmosis process. In your foot spa, or a basin, you can create a salt solution. Fill the bath just about half way, and add half a cup of Epsom salts. If you have any blisters, they will heal with time. Additionally, via osmosis, with a concentrated salt solution, you can detox as the salts in the water, will pull toxins from your body through the pores in the soles of your feet. The soles of your feet are actually very sensitive and porus.  

  3. Foot Scrub: After you have soaked your feet, you can facilitate exfoliation by using a foot scrub to massage the feet. You can create your own scrub via a mixture of coffee (after you’ve percolated it and have the ground coffee left over), coconut oil and brown sugar. Apply gently, and let the scrub nourish your feet. 

  4. Foot Cream: With aromatherapy becoming more mainstream, you can actually determine what scents to apply to your feet in order to give yourself a boost. If you’re heading to sleep you can apply a lavender lotion. These are very inexpensive and you can find them in your local pharmacy, near to lotions and candles. If you want to energize your body, you can actually apply an invigorating scent like a mint or citrus scent that will energize the senses once they are stimulated.

Once you are finished, you can simply go through the process of either placing your feet into socks, or if you’re heading out for the day into your favorite comfortable sandals. Pamper yourself today. 

Reference Article: 

  1. Post WorkOut Foot Pampering: https://www.verywellfit.com/best-ways-to-pamper-your-feet-3435790

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Foot Massages For Better Health

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Image Credits: Kilburn Spa London 

“Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity.” - John F. Kennedy

Your health is your wealth. The feet are generally the often neglected portions of the body. As with all conditions, most people don’t pay attention to their feet until there’s a significant problem with them. Ideally, prevention is better than cure. As a multi-functional hinge joint which does more than bear the weight of our bodies, our feet transport us from one location to the next. With time, this portion of our bodies can suffer from wear and tear. As part of your general maintenance routine, a scheduled foot massage along with healing therapies such as reflexology is genuinely advised. The benefits are felt not only in the physical being, but also in the mental realms. 

The art and science of reflexology, is a traditional yet healing practice that stimulates various reflex points on the feet. As a system, the entire body is connected, and it just so happens that there are points on the feet which are connected to major organs and glands. Statistically, the feet has the following characteristics: 

42 muscles 

26 bones 

33 joints 

250,000 sweat glands 

50 ligaments and tendons 

15,000 nerve endings

As a marvel of genetic engineering, we must not take our feet for granted. Many of us, particularly women, do take the time to massage our feet every now and then when we go for pedicures. The fact is that we should all be taking the time to do this activity. The benefits of massages are numerous. After an injury for instance, muscle soreness can be reduced and recovery can be enhanced. Additionally with an increase in flexibility, the odds of injury are significantly reduced. 

Since knowledge is power, let us delve into the benefits of foot massages: 

  1. Lower Blood Pressure: Studies have shown that there is a significant reduction in the systolic pressure of patients who received reflexology treatments. 

  2. Reduction of Edema: Swelling of the body due to accumulated fluids, induced by trauma, is known as edema. Patients who suffer from diabetes, as well as pregnant women, are prone to such a condition. With regularly scheduled massages, the blood circulation of the feet were improved, and edema minimized due to the simulation of the area. 

  3. Improved Relaxation: As the pressure on the feet is released via stimulation, health is found to increase. Modern life has us mostly seated, and feet muscles aren’t exercised as they should. As a result, blood flow to the region is reduced. The corporate world induces the wearing of tight shoes such as high heels, which hinder circulation. With a foot massage at the end of each day, the health of an individual can be optimized, as circulation is restored to the feet. 

  4. Relaxation: The modern world induces stresses, which we are often not aware of. In the workplace, there is competition, and if you live in a metropolitan area, you may often have to park and walk to your destination. With the built in stress that is induced you can release it at the end of the day, via a foot massage. The action of rubbing the feet is actually soothing to the body. With an appropriate foot massage, relaxed bodies lead to better sleep and better moods. 

  5. Healthier Feet: A gentle foot massage of about 5-10 minutes is an ideal way to promote foot flexibility. Pamper and heal via massaging your feet with warm olive oil, coconut oil, or even your favorite aromatherapy oil such as lavender. As you do, will be able to relieve yourself from the symptoms of conditions such as foot tendonitis, but also induce relaxation in the process. 

Foot care can be of a minimally invasive nature, and scheduling a nightly foot massage for yourself and your partner right before bed will ensure that your entire body is healed. 

For a Foot Massage Tutorial, view the following YouTube Video: 

How to Give a Stress Relieving Foot Massage 

Reference Article: 

7 Benefits of Foot Massage: https://www.foot.com/7-benefits-foot-massage-reflexology/

Happy Feet: https://www.happyfeet.com/blog/four-life-changing-benefits-of-a-simple-foot-massage/


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Minimally Invasive Key Hole Corrective Surgery for Bunions

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“Health is a large word. It embraces not the body only, but the mind and spirit as well; …and not today’s pain or pleasure alone, but the whole being and outlook of a man.” -  James H. West

If you’ve experienced the pain of a bunion, you are not alone! They have always existed and your orthopaedic surgeon will be able to facilitate your healing. Scientifically known as Hallus Valgus, bunions develop as the alignment of the body is impacted by various factors. Bunions are more prevalent in women than in men, and can be induced by wearing shoes that are narrow or constricted. They are also handed down from generation to generation via genetic inheritance, and induced by medical conditions such as arthritis. 

What causes Bunion Formation? 

When bunions form, the result is the movement of the great toe towards the extremity of the foot. There is a lateral shift that is caused by the shifting of the first metatarsal bone. The shift in the bone causes its head to protrude, and eventually starts to put pressure on the skin from the inside out. The resultant pressure causes the foot to rub against shoes. The protrusion causes a thickening of the skin, and the area becomes quite painful to the touch. 

Treatment Options For Bunions

There are a myriad of treatment options for bunions, depending on the severity of the condition. The first preventative measure is the insertion of footwear modifiers. These can include soft insoles that cushion the area. Because the foot undergoes an expansion of the width of the foot, there will eventually be a limit to the shoes that can be purchased. Corrective action via minimally invasive surgery is an option that you will have to investigate. The treatment that facilitates the treatment of bunions is the minimally invasive keyhole corrective surgery. 

As a start, you will consult with your orthopaedic surgeon, who will assess your current condition. Via a series of both external checks, and internal checks such as via an MRI or an X-ray, the severity of the protrusion can be determined. 

How is a Key Hole Correction Conducted? 

The image above, is a case of a patient with a bunion. The treatment for this bunion was a minimially invasive key hole procedure. The case was treated in the day, the outcome was immediate weight bearing, with no plaster required. As medical technologies evolve, there is a transition between keyhole surgery, and open bunion surgery which is the more traditional methodology. Keyhole surgery is proving to be reliable, and is showcasing advantages compared to open surgery. From a cosmetic perspective, there are much smaller scars present after surgery, due to the smaller incisions made, which makes the healing process more pleasant. When open surgeries, the larger scars can induce higher risks of infection. 

The additional benefit to keyhole bunion surgery, is the fact that there is minimal disruption of soft tissue, resulting in reduced pain and swelling post surgery. The patients are able to walk much sooner than those with open surgery and recover faster, with the help of physical therapy. 

During your keyhole surgery, your orthopaedic surgeon will perform a procedure known as minimally invasive bunion surgery (MIS) or minimally invasive chevron Akin bunion surgery (MICA). The procedure will involve the introduction of very small incisions centred around the bunion. The surgeon will then make a series of cuts, removing segments of bone until the foot is normalized in terms of dimensions. The following is the image of the patient, after surgery.


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With the aforementioned benefits of the surgical procedure presented, if you have a bunion, talk to your orthopaedic surgeon and identify if this path will be the one for you. Your health is your wealth. With keyhole surgery, you will be able to walk right after the procedure. You will be supported with crutches, and your feet will be covered with soft bandages for approximately two weeks. Within four weeks, you will be able to resume physical activities. 

References: 

Minimally Invasive Key Hole Surgery: https://www.croydondayhospital.co.uk/treatments/bunion-surgery/minimally-invasive-bunion-surgery


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Growth Factors for Arthritis

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Image Credits: Slideshare 

“Give a man health and a course to steer, and he’ll never stop to trouble about whether he’s happy or not.”- George Bernard Shaw

Arthritis, is a condition that can be potentially debilitating. As a patient, you probably have realized that not all arthritis treatments are the same! You have probably tried everything under the sun, from the over the counter treatments to even the point at which you are considering surgery as an alternative to healing your persistent pain. Once you start your treatments, you realize that how you feel varies per day. You have your highs, and then you have your lows. If your pain point is high enough, you’ll be better able, with the help of your orthopaedic surgeon to find a path that will result in the best restorative treatment. Thankfully there are evolving technologies like growth factor treatments that will help your body to self heal. Under Australian policy, you will be compensated for this treatment, so you won’t have to worry about financing. 

What exactly is a Growth Factor Treatment? 

Growth Factor Treatments fall into the category of protein therapies, which help the body to naturally heal itself. As you can see from the image above, the growth factor is a  protein molecule that operates via a lock and key mechanism, to facilitate the healing process. From the study of the human body, over time with arthritis, an individual can lose their cartilage and bone due to the degenerative condition. With the evolution of therapies, it is now becoming increasingly possible to facilitate the restoration of both the bone and cartilage that was lost due to osteoarthritis. With aging populations globally, the incidence of osteoarthritis is on the rise, and the challenge in the treatments that currently exist is in the regeneration of the joint tissue that provides motion and flexibility to the hinge joint that is your ankle. 

Via growth factor treatments, the special proteins or “growth factors” that are suited for therapeutic properties are administered to the healing site. These proteins are suited for tissue repair and regeneration and supplied via platelet rich plasma. The growth factors are multi-functional, with some elements having specific functions that will enhance cartilage regeneration. In terms of their scientifically identified focuses, there are elements such as PDGF which helps with collagen regeneration and EGF that facilitates cellular proliferation. 

The specific healing properties have been identified, which helps to determine their applications in your therapy. Scientific studies began in the knees, and have also been applied to ankle joints as well. The success of treatments have shown that there is a decrease in pain, increase in range of motion and joint function in the treated patients. 

When is the best time to approach your Doctor about Growth Factors Treatments?

There is no best time to approach your doctor, but if you feel that you’ve reached a point where you want to try new therapies, either in the early stages of your therapy, or if you feel your current therapy isn’t sufficient, organize to discuss the evolving technology with your orthopaedic surgeon. Your doctor will then identify the series of PRP intra-articular injections as part of your treatment plan. These can be administered either as a treatment plan on their own, or alternately as a combination with surgical procedures such as microfractures. As an evolving technology, the treatment is evolving in the right direction. Allowing your body to self-heal is a path that is worth considering. 

Reference Articles: 

  1. Science Daily: https://www.sciencedaily.com/releases/2019/02/190219143510.htm

  2. Growth Factors in the treatment of Osteoarthritis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710006/

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Foot Care For Diabetics

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Image Credits: Times of India

“The really important thing is not to live, but to live well… and to live well means the same thing as to live honourably or rightly.” - Socrates

Diabetes is just a word, not a sentence to a miserable life. While the treatment can be potentially dangerous, as a patient, you can actually look at it as a means to improve your ability to take care of yourself. Studies have shown that stress induces illness, so if you put yourself in a situation where you reverse the root causes of your conditions, you will heal. 

Diabetes and Peripheral Artery Disease (PAD) 

Diabetes and Peripheral Artery Disease (PAD) often go hand in hand. As a cardiovascular condition, with induced restriction of the blood vessels, many diabetics often develop a condition known as peripheral neuropathy. Patients that have peripheral neuropathy often lose sensations in their extremities, and in the instances of any cuts or bruises on the body, patients may not be aware of them, and ulcers can ultimately develop. With time, the ulcer can become infected. PAD is the ultimate breeding ground for amputation. 

Foot Care for Diabetics 

There are a few key activities, which will lead to great foot health. As with all things, prevention is better than cure. The following should be part of your pamper routine if you’re a diabetic: 

  1. Daily Foot Inspection: Take good care, and take the time to inspect your feet at one specified time each day. This could be in the evening once you are getting ready for bed. After your shower, you can take the time to check your feet for any bruises, swelling or ingrown toenails that can affect the health of your feet. A great tool to have is a hand held mirror, so that you can see the base of your feet, and the back of your heels. If you still can’t manage, you can use this as an opportunity to have your partner or your children check for you. 

  2. Lukewarm Baths: The more you nurture yourself, the better you’ll feel and the more that you’ll heal. Warmth improves your blood’s circulation. With a daily wash of your feet, with warm water you facilitate the dilation of your blood vessels, and improved circulation of your blood. This facilitates healing. If you so desire, you can add essential oils to your bath and raise the healing properties of the water. Wash your feet with a soft washcloth, and carefully dry them after your bath. Allow them to air dry. 

  3. Moisturize Your Feet: Your feet have skin as their primary cover. Skin loves and needs moisture in order to heal itself. Use a moisturizer such as Eucerin or Vaseline to keep your skin moisturized and minimize the occurrence of dryness or cracking. Air dry your feet to minimize fungal infections. 

  4. Adequate Foot Care: This is the time of your life, where pedicures should be a standard. When you’re cutting your nails, ensure that they are cut straight and filed. Do what you can to minimize the occurrence of ingrown toenails, because the induced cuts can lead to ulcers. If you see a cut or wound, see your doctor. 

  5. Wear Diabetic Socks: With added cushions, these are special socks that will help you to keep the socks clean and dry. When it comes to your footcare, check your shoes carefully to ensure that there is nothing inside them before you wear them. Since such objects can cut the feet, it is critical to ensure that the feet are protected in their shoes. 

  6. Keep Your Feet Clean and Dry: As strange as it may seem, an antiperspirant on your feet will keep them dry. 

This list is by no means exhaustive, but it is a great start to your diabetic foot care. As with all medical conditions, do consult with your orthopaedic surgeon, in order to ensure that you are getting the appropriate care. Your health is your wealth! 

 

References: 

  1. Diabetes Footcare Guidelines: https://www.foothealthfacts.org/conditions/diabetic-foot-care-guidelines

Lower Extremity Amputations and Diabetes

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Image Credit: Medical News Today

“What is called genius is the abundance of life and health.” - Henry David Thoreau

Diabetes, as a medical condition is a global concern for a variety of reasons. As a potentially debilitating condition that impacts the blood sugar level of an individual, there is an innate tendency for the body to not be able to manage its insulin generation. The two types of diabetes are Type 1 and Type 2 diabetes. This article will focus on the impact of Type 1 diabetes on amputation cases. 

Type 1 diabetes occurs when the body, in an autoimmune response, attacks its own pancreas, and inhibits the ability of the organ to generate insulin. Insulin management is key to health, and requires consistent monitoring. Treatment of Type 1 diabetes includes insulin intake via injections or more recently, the use of insulin pumps to regulate the hormone. 

Australia, as a nation houses approximately 1 million diabetics. Of this total, approximately 10% are diagnosed with Type 1 diabetes. Diabetes Australia studies have indicated that the annual cost of medical treatment for Type 1 diabetes is on the order of magnitude of $570 million. Individual patient cost averages $4669.00. With a range of costs depending on the severity of the condition, those patients who are ailing from a combination of both diabetes and cardiovascular conditions can expect their individual health costs to be as high as $16,698.00. 

The root cause of the increased medical costs for diabetics with cardiovascular diseases is influenced by the downstream conditions that are induced by the fusion of ailments. One downstream condition that has had statistical impact for individuals with Type 1 diabetes is the onset of lower extremity amputations. Medical research was able to identify that of a group of control vs patients with Type 1 diabetes, the absolute risk of amputation was up to 40 times higher.  

The research team focused on medical parameters such as diabetes duration, glycemic control, and renal complications. With each parameter monitored, the lowest risk for amputations, was with patients that adequately managed their glycemic levels, as well as maintained good renal health. Diabetes and amputations have always been directly correlated. If you are diagnosed with diabetes, a good prevention plan will ensure that you prevent a condition that has both economic and social impact. Amputation is preventable. 

Diabetes and Peripheral Artery Disease (PAD) 

Diabetes and Peripheral Artery Disease (PAD) often go hand in hand. As a cardiovascular condition, with induced restriction of the blood vessels, many diabetics often develop a condition known as peripheral neuropathy. Patients that have peripheral neuropathy often lose sensations in their extremities, and in the instances of any cuts or bruises on the body, patients may not be aware of them, and ulcers can ultimately develop. With time, the ulcer can become infected.  

PAD is the ultimate breeding ground for amputation. Where there is reduced blood flow, the healing properties of the body are significantly reduced. The wound therefore, either will heal very slowly, or not at all. With the onset of gangrene, the ulcer can affect the bone. Gangrene is a condition that medical personnel will then have to manage either via harvesting the existing limb and attempting to restore life to the area, or in the extreme case, the limb will have to be amputated. Many diabetics have lost a toe, their feet, or even the lower leg as indicated in the image above. 

How to Manage Amputation

The good news, is that amputation is preventable. If you are diabetic, constantly seek medical attention and ensure that you are inspecting your limbs on a daily basis. If you can’t reach your extremities, have your spouse or children help you to ensure that you are healthy. Good medical practices for diabetes management include: 

  1. A healthy, balanced diet that helps to regulate your insulin. Consult with a nutritionist to determine what foods are best for your body. 

  2. Minimize your sugar intake

  3. Relax 

  4. Exercise constantly. This activity does not have to be strenuous. At least 30 minutes of activity per day will help your body to stay in tune, and your cardiovascular system to stay at its peak. 

  5. Ensuring that all doctor’s recommendations are adhered to. 

  6. Daily Foot checks

To reiterate, you don’t have to become an amputee if you’re a diabetic. With appropriate health management, you can live a long and healthy life.

References: 

  1. Open Access Research: Excess risk of lower extremity amputations in people with type 1 diabetes compared with the general population: amputations and type 1 diabetes

  2. Healthline: https://www.healthline.com/health/diabetes/diabetes-amputation

  3. Diabetes Australia: https://static.diabetesaustralia.com.au/s/fileassets/diabetes-australia/e7282521-472b-4313-b18e-be84c3d5d907.pdf

Ankle Fusion

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Image Credits: Orthobullets 

What is Ankle Fusion? 

There is a point in every arthritis sufferer’s life where a choice has to be made. That choice is often whether or not to have an ankle fusion therapy treatment, or to opt for ankle replacement therapy. Thankfully, your orthopaedic surgeon will take you through the decision matrix that will determine what path will be ideal for your lifestyle. 

Symptoms of Ankle Arthritis

If you are experiencing the following sensations in your ankle, you are a prime candidate for arthritis.

*Loss of smooth cartilage on the surface of the tibiotalar joint bones

*Pain 

*Inflammation 

*Swelling in the Ankle Joint

Consult with your orthopaedic surgeon to determine how acute or severe your condition is. Your consultation will often involve a detailed assessment of your medical history. Via a deeper insight of the joint via scans like MRI’s or X-Rays, the internal condition of your ankle joint can be determined. If your condition is acute and you are below the age of sixty, your orthopaedic surgeon will recommend that you be treated via ankle fusion surgery. 

What is Ankle Fusion? 

The ankle is a joint composed of a series of bones. As the joint degenerates, it will often be imperative for the surgeon to restore the joint via a fusion treatment. As the integrity of the ankle joint is lost, the surgeon will restore it via a series of internal scaffolds, that enable the joint’s strength and flexibility to be restored. As indicated in the image above, your orthopaedic surgeon will affix to your joints a series of plates and screws that will support the joint. 

During the surgery, there will be an incision made, that will expose the ankle joint. The surgeon will then create the scaffolding on the bones, and reinforce the joint. In some instances, there will be the addition of a bone graft, in addition to the metallic hardware that is added to the joints. Enquire with your surgeon if your treatment can be facilitated via a minimally invasive surgery. 

Post Surgery Treatment 

Once an ankle surgery is completed by the orthopaedic surgeon, the patient usually spends the night, and then is released the next day once all the patient checks are completed. The treated leg is often placed in a cast and the patient is allowed to be mobile via crutches or a walker. 

During post operative treatment, it is advised that the patient minimize weight placement on the restoring ankle joint. The fusion process takes up to twelve weeks to facilitate the initial healing phase. The time frame for complete healing is up to six months. 

While no treatment is one hundred percent effective, your treatment will facilitate the restoration of normal physical activity. Your health is your wealth. With careful research and discussion with your doctor, you’ll feel confident that your therapy is the best path forward for you. 

Reference: 

Ankle Fusion: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/ankle-fusion

Ankle Replacement for Arthritis

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Image Credits: Wall Street Journal 

“I have chosen to be happy because it is good for my health.”- Voltaire

What is Ankle Replacement Surgery for Arthritis? 

All arthritis treatments are not the same! Depending on the extent of ankle joint degeneration,  minimally invasive intervention or even orthopaedic surgery may be warranted. If you are experiencing variable sensations on a daily basis - it may be time for a stabilizing treatment. Ankle replacement surgery may be the solution to your ankle pain. As a surgical option for the treatment of arthritis, consult with your orthopaedic surgeon in order to determine if this is the path for your healing. Ankle replacement surgery is an alternative therapy to ankle fusion. 

As a complex therapy, ankle replacement is often the last resort therapy if alternatives haven’t worked for a patient. During your consultation, your doctor will assess your medical history and determine if you’ll be a prime candidate for ankle replacement surgery. Distraction arthroplasty is also possible option in certain arthritic ankles. Since recovery can take up to twelve months after surgery, various factors will have to be decided on, before the decision is made and the acute treatments have proven ineffective.

Arthritis of the Ankle 

Also known as the tibiotalar joint, the ankle joint incurs cartilage loss through a variety of various root causes leading to arthritis. Ankle fusion therapies include fusing damaged ankle bones with a series of metal plates and screws. The intention is for the bones to actually heal into one. With the benefit of improved joint integrity, with a downside of limited mobility. Arthritis isn’t completely healed by ankle fusion, however, it is a therapy that is prevalent due to its effectiveness. No therapy is one hundred percent effective. Research and consultation will determine the best path forward. Orthopaedic surgeons favor ankle fusion in younger patients. With ankle fusion, physical activity can be resumed once the joint has healed. 

Ankle replacement, involves joint restoration via the removal of the joint internals, and replacing them with prosthetics. These are synthetic joints which are made of plastic and metal, as indicated in the image. The original joint was damaged, and replacement joint aims to restore the damaged portion of the joint. With joint replacement, there is increased mobility, but still has the ability to regenerate arthritic conditions. Ankle replacement surgery is often prescribed for patients over the age of sixty, who restrict their physical activity. 

What are the Post Surgery Treatments? 

If a replacement surgery is performed on a patient, the patient will be required to release weight from the treated leg. There will often be a protective splint on the leg. The patient will also be mobile via the use of crutches. During the healing process, there will be the incorporation of physical therapy exercises to ensure that joint mobility is properly restored. The joint has to fuse into the surrounding healing ankle joint. The body can either accept or reject the joint, so it will be important for the careful monitoring of the site to be facilitated via the various specialists who monitor the site. 

Your orthopaedic surgeon will ensure that your surgery and your treatment path go as planned. Have a detailed consultation with your specialist, if you feel that this will be the ideal path for you going forward. Your health is your wealth. 

Reference Articles: 

  1. Total Ankle Replacement Surgery for Arthritis: http://www.orthop.washington.edu/patient-care/articles/ankle/total-ankle-replacement-surgery-for-arthritis.html

  2. Considering Ankle Replacement Surgery: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-considering-ankle-replacement-surgery/

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Approved Stem Cell Usage In The United States

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Image Credits: Docwire News

“Health is a large word. It embraces not the body only, but the mind and spirit as well;…and not today’s pain or pleasure alone, but the whole being and outlook of a man.”-  James H. West

The medical field is coming full circle. Early in our existence, there was a reliance on natural therapies to heal the body’s ailments. Food was our medicine, and medicine was our food. With the advent of technology, there was an emergence of medical procedures, and synthetic drugs that were able to heal the body. While synthetic drugs have their use, they do often have adverse side effects that can cause the patient to often opt not to take the medicine. As an alternative, researchers delved into a world where they could simply allow the body to heal itself. This revolution, led to the discovery of the healing properties of stem cells. 

What Type of Stem Cell Therapies Are Approved By The FDA? 

The FDA is the regulating authority for the approval of stem cell products in the United States. The types of stem cells used for treatments include stem cells from embryonic sources, as well as adult stem cells derived from bone marrow or fat. Although there are a variety of stem cell clinics globally, the majority of them operate with a disclaimer. They are not actually FDA approved. The FDA has approved products from only one source of stem cell - that from blood-forming stem cells (hematopoietic progenitor cells) derived from cord blood. 

The field of stem cell biology is a very complex one. Some of the factors that influence the lack of regulation of the majority of stem cell products is due to the following factors: 

  1. The intricate nature of the genetics of cell development 

  2. The approval phases go through various scales from pilot to full scale trials in humans. Not all results observed in testing lab animals such as mice, scale up to the equivalent in humans. 

  3. The transplanted stem cells may not develop into the desired cells. A deeper understanding of cell biology will be needed to correctly engineer the types of cells needed for the desired therapy. 

  4. The body’s immune response to any injected substances may not be favorable. The body can attack the stem cells in an effort to protect itself as an immune response. It may take a while for the cells to be accepted by the body. 

As the field evolves, and deeper knowledge is gained, there will be an improvement in the available therapies. At best, the existing facilities that are non-FDA approved, are helping to increase the pool of knowledge that exists in the field via clinical trials. 

As a fact, there are stem cell clinics all over the United States, that patients have access to for the treatments of conditions such as cancer, multiple sclerosis, Alzheimer’s and arthritis. Using therapies such as fat derived stem cells, the cells are re-injected into the body to facilitate healing. With minimal evidence, be careful of stem cell clinics that are not FDA approved. There are action steps being taken over the next three years, in order to facilitate their regulation. The primary concern is due to the fact that there are potential adverse side effects which could be detrimental to the patient. With unregulated therapies, there is limited protection if a patient reacts to the treatment.

The benefits of stem cell treatments outweigh their risks, or else there won’t be 570 stem cell clinics in the United States. FDA regulation has been known to take several years, and many doctors are able to access therapies via disruptive technologies that are able to treat patients for conditions that were once considered to be debilitating. Patients are now recovering from conditions such as multiple sclerosis and arthritis thanks to the advent of stem cell therapies. 

Speak to your orthopaedic surgeon, about stem cell therapies. It is an emerging technology that could heal your body with its own natural mechanisms. 

References: 

  1. Rising Tide Biology: https://www.risingtidebio.com/history-stem-cell-therapy-benefits/

  2. Vox Publication: https://www.vox.com/2019/1/9/18173772/stem-cell-therapy-fda

FDA: https://www.fda.gov/consumers/consumer-updates/fda-warns-about-stem-cell-therapies

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