Volume 22 - Issue 1 - January 2009

Point-Counterpoint »

Is Cartilage Grafting Better Than Drilling For Osteochondral Lesions?

By Tom Chang, DPM and By Thomas Brosky II, DPM | 10782 reads | 0 comments

Yes, Tom Chang, DPM cites recent advances in the use of autografts and allografts, and emphasizes that hyaline cartilage is more durable than fibrocartilage.

   The last few years have seen the introduction of evolving techniques for osteochondral defects for talar lesions. These techniques include the use of autografts and allografts in single plugs or mosaic patterns.

   Surgeons have utilized similar techniques for chondral defects in the metatarsal heads as well. The degenerative changes in patients with hallux valgus or hallux limitus can prese



Feature »

When Conservative Care Fails For Tendinopathies

By Paul J. Kim, DPM | 13044 reads | 0 comments

Patients with tendinopathies can undergo conservative care for months without resolution of the condition. Delayed presentation is often an issue as well. Accordingly, this author emphasizes the differences between tendinopathy and tendinosis, and offers salient insights on surgical modalities and procedures.

   At podiatric medical conferences, one will see rows and rows of vendors displaying a wide variety of products involving fixation of bone. However, there are very few vendors who display products that foot and ankle surgeons can use in the treatment of tendon



Feature »

Empiric Antibiotics: A Guide To Appropriate Use

By Eliza Addis-Thomas, DPM, Peter Blume, DPM, FACFAS, and Jonathan Key, DPM, FACFAS
 | 22299 reads | 0 comments

Given the challenges of selecting appropriate empiric therapy with the rise of antibiotic resistance, these authors offer a review of the literature in regard to diabetic foot infections. They offer pertinent insights on infection severity, common pathogens and other factors in choosing the right agent.

   While antibiotic therapy for infection is typically empiric at the outset, making the right call is not easy. If physicians make a too narrow selection in terms of antibiotic coverage, they may miss the offending organism. Conversely, choosing a too broad antibiotic



Wound Care Q&A »

Facilitating Improved Documentation In Wound Care

Clinical Editor: Kazu Suzuki, DPM | 16617 reads | 0 comments

   Having effective and thorough documentation methods can enhance outcomes, improve efficiency and help reduce hurdles to timely reimbursement. These panelists draw on their experience to discuss exactly what one needs to document in charts and how to use technology to make documentation easier.

Q: What are the recommended methods for the wound care documentation?

A: In addition to documenting patient care, Caroline Fife, MD, notes that the medical record supplies information for quality assurance and the data needed to determine the billed revenue for physi



Surgical Pearls »

A Closer Look At The Mini-Open Ankle Arthrodesis

By Sean Grambart, DPM | 11488 reads | 0 comments

   Joint sparing procedures include total ankle arthroplasty, distraction arthrodiastasis and allograft total ankle replacement. However, the gold standard is still ankle arthrodesis.

   Traditional exposure for ankle arthrodesis has been through the open transfibular approach. This approach usually involves a fibular takedown osteotomy but researchers have described a medial malleolar approach.1 Unfortunately, this technique has the disadvantages of a larger skin incision that can lead to wound dehiscence and increased risk of postoperative infecti



Diabetes Watch »

When Patients Ask About Online Information On Products And Procedures

By Andrew J. Meyr, DPM and John S. Steinberg, DPM | 14879 reads | 0 comments

   For better or for worse, we live in an “As Seen on TV” culture. Often, our patients come to us with their own thoughts and ideas based on a commercial that they saw on late night television, an advertisement from the magazine on an airplane or something that they have “researched” on the Internet.

   We would venture to guess that a week does not go by when a patient comes into your office with a specific question about a newspaper clipping or something that he or she has printed off the World Wide Web.