New AFO Device Offers Enhanced Customization And Multiple Indications

By Anthony Leone, Special Projects Editor

     Earning raves from podiatrists, the Total Control Orthosis (TCO) Active offers a variety of features, facilitates easy customization and one can utilize the device for a variety of podiatric indications.      According to Langer, the manufacturer of the device, podiatrists can use the TCO Active to help treat common conditions such as mild posterior tibial tendon dysfunction and chronic ankle instability as well as dropfoot and high ankle sprains.      Langer says the TCO Active is a hydrostatic, custom ankle foot orthosis (AFO) that facilitates support and stabilization of the midtarsal, talocalcaneal and subtalar joints. Featuring the Free Motion or Dorsi-Assist ankle joint, the device can be beneficial in managing abnormal motion or severe pronation in the transverse and frontal planes.      After 10 years of using similar devices, Babak Baravarian, DPM, has utilized the TCO Active for a year and says it is a very effective option.       “It can be customized for patients with different deformities. It helps manage their individual problems,” notes Dr. Baravarian, the Co-Director of the Foot and Ankle Institute in Beverly Hills, Calif.      Jeff Lerner, DPM, concurs. He has used the AFO a dozen times and has found the “TCO Active to be a really well-made product.”

Key Insights On Customization Benefits

     After one has decided to use the device, Dr. Baravarian says the podiatrist takes a mold of the affected lower extremity and gives specific directions to Langer as to how the brace should be designed for that particular patient.      Dr. Lerner adds that one can create molds for the device in any setting, whether the DPM is in a private practice or at a hospital, as long as he or she has all the materials.      Within two to three weeks, the patient should be walking better with his or her new TCO Active, according to Dr. Baravarian.

Other Pertinent Considerations

     Dr. Baravarian says some of the candidates for the TCO Active include those with flat feet, ankle injuries, tendon tears and even arthritis in the foot and ankle. He says it is a solid conservative treatment option for patients who do not need surgery or those who do not want surgery. Dr. Lerner, who is in private practice in West Palm Beach, Fla., agrees.      Dr. Baravarian adds that the device is also conducive for postoperative management.      In addition, the company notes the device can steady the ankle area medially and laterally.

Final Notes

     One should give patients a few words of caution when they use the TCO Active for the first time, suggests Dr. Baravarian. He says some patients may experience irritation when using it. Dr. Baravarian also suggests that the patient should not use it all the time and allow the body time to get used to the device.      For example, he says a patient with flatfoot and a tendon tear had some difficulty adjusting to the device at first. “He needed time to break it in,” notes Dr. Baravarian.      Ensuring a proper fit is important. If the brace is not fitted or made correctly, it can be very painful for the patient, cautions Dr. Baravarian. He does add that Langer’s TCO Active has a benefit in that it is easily adjustable with the use of support straps.      Dr. Lerner adds that one can also send the TCO Active back to Langer for modifications if necessary.

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