How The KobyGard System Provides A Surgical Solution

By Robi Garthwait, Contributing Editor

   Chronic plantar fasciitis and Morton’s neuroma are two persistent conditions that podiatrists frequently see among their patients. However, practitioners are seeing results with a surgical system that succeeds when conservative treatments fail to alleviate these conditions.    The KobyGard System (OsteoMed) enables surgeons to isolate and cut both the transverse metatarsal ligament and plantar fascia through a small incision. The system is comprised of a variety of instruments including a tissue locator, a ligament separator, a fascia separator, the KobyGard flex tip instrument in addition to a single-use blade. The instrumentation allows for a precise, predetermined cut of the ligament or fascia without damaging surrounding tissues, according to the company.

Tackling Morton’s Neuroma

   When initial therapies such as a change in footwear or orthoses fail to work, surgeons say the KobyGard System is making a big difference for patients suffering from chronic neuroma pain.     “I have seen an 85 percent resolution of neuroma complaints without having to take out the neuroma,” notes Bruce Werber, DPM, a Fellow and Past President of the American College of Foot and Ankle Surgeons (ACFAS).    Dr. Werber, who practices in Warwick, R.I., also points to a reduced risk of infection and complications in patients who have been treated with the KobyGard System for Morton’s neuroma.     “I have been quite satisfied utilizing this minimal incision technique to alleviate patients’ complaints of forefoot pain,” he says.    Joshua Gerbert, DPM, FACFAS, agrees with Dr. Werber regarding the KobyGard System’s effectiveness in treating nerve decompression of the intermetatarsal space.     “The results to date have been very good in that 90 percent of patients have been symptom-free following this procedure,” notes Dr. Gerbert, who practices at St. Mary’s Medical Center in San Francisco and is a Professor in the Department of Podiatric Surgery at the California School of Podiatric Medicine at Samuel Merritt College.    He also points out that patients are immediately mobile and experience little discomfort.     “The technique allows for minimal postoperative disability,” says Dr. Gerbert, adding that patients can return to wearing regular footgear at one week. He also finds patients are more accepting of this procedure as compared to the excision of an intermetatarsal nerve.

Can It Provide Relief For Chronic Plantar Fasciitis?

   Dr. Werber has experienced similar success treating plantar fasciitis using the KobyGard System’s tools.     “This is a very easy, minimally invasive system that enables you to release the plantar fascia in a protected fashion,” explains Dr. Werber.    He says the results are comparable to other plantar fascia procedures, including endoscopic plantar fascia release and open plantar fascia release. However, it has the added advantages of a small incision and protection of the surrounding tissue.    Dr. Gerbert has had less success using the system to treat chronic plantar fasciitis in which there is also a nerve entrapment. He has also encountered patients who have an exceptionally thick plantar fascia, which the KobyGard System could not accommodate.

Final Notes

   Drs. Gerbert and Werber both cite the KobyGard System’s ease of use and minimal learning curve as key features of the product. Both would recommend the system to other doctors.     “The system that uses the fiberoptic scope requires much more time to set up and perform the procedure as compared to the KobyGard,” states Dr. Gerbert.     “Alternative minimal incision techniques in alleviating neuromas include the endoscopic procedure by Instratek. However, this requires many more instruments to visualize the intermetatarsal ligament and there is a steeper learning curve,” says Dr. Werber. “That is why I prefer using the KobyGard System for neuroma decompression.”

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