The Top 10 Innovations In Podiatry

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Brian McCurdy, Senior Editor

   Augmatrix is approved for use in combination with autogenous bone marrow, notes Peter Blume, DPM, FACFAS. He says the product is composed of synthetic carbonated apatite and bovine type I collagen in a 55:45 ratio (w/w). The manufacturer Biomimetics Therapeutics notes the carbonated apatite component closely resembles the mineral phase of bone and Augmatrix granules provide an enhanced osteoconductive scaffold that supports bone remodeling. The carbonated apatite disperses throughout the collagen matrix and the entire construct is 80 percent porous, which Dr. Blume says allows for absorption of bone marrow aspirate and stem cell attachment.

   “Augmatrix is an exceptional osteoconductive graft with osteogenic potential (provided by autogenous stem cells) and an innovative option for bone repair,” says Dr. Blume, an Assistant Clinical Professor of Surgery, Anesthesia and Orthopedics and Rehabilitation at the Yale School of Medicine. “As an off-the-shelf product, Augmatrix represents a cost-effective alternative to autograft that spares patients additional pain and morbidity from a bone graft harvest site.”

   Dr. Blume says Augmatrix does not carry an allogeneic risk. He also points out that the product has improved handling characteristics in comparison to commercial allografts and provides an added benefit from live autogenous stem cells when mixed with bone marrow aspirate. Dr. Blume says Augmatrix contains a higher percentage of collagen at 45 percent in comparison to similar synthetic products that contain an average of 20 percent or less. The higher collagen content provides for efficient absorption of bone marrow aspirate, adds Dr. Blume.

Can Amniotic Membranes Have An Impact In The Lower Extremity?

9. Neox (Amniox Medical). Amniotic membrane has had proven success in eye surgery for years as an anti-inflammatory and anti-adhesive barrier. Christopher Hyer, DPM, has been using the Neox human amniotic membranes for about a year in foot and ankle cases, and has seen good results.

   The manufacturer Amniox Medical says Neox uses the Cryotek process, which can deliver the membranes to surgeons in a hydrated form, preserving its natural elasticity and saving time in the OR. The company adds that one can cut Neox to size and suture it in place.

   Dr. Hyer, a Fellow of the American College of Foot and Ankle Surgeons, notes there are “no other products out there” to reduce and prevent scarring or adhesions in a postoperative setting. He says artificial products like silicone sheathes are not effective and elicit foreign body reactions. In contrast, he says the anti-scarring properties of amniotic tissue are very useful around tendons and nerves.

Is There A New Solution For Dystrophic Nails?

10. Nuvail (Innocutis). Dystrophic nails can be an issue for patients with onychomycosis but a new non-pharmaceutical modality may provide a solution.

   Nuvail (Innocutis) is a topical nail polymer that does not have a pharmaceutical agent and is indicated for dystrophic nails, according to Dr. Vlahovic. She says one can use it in conjunction with other onychomycosis therapies such as laser treatments and orals, or psoriatic nail therapies.

   Dr. Vlahovic cites a clinical trial showing that 60 percent of patients had improvement in their nail appearance at six months just with using Nuvail.1 She notes that Nuvail recently received the approval of the Food and Drug Administration.

   Dr. Vlahovic adds that Nuvail is advantageous in that it forms a waterproof barrier so patients do not have to reapply the topical each time they get their nails wet.

1. Nasir A, Goldstein B, van Cleeff M, Swick L. Clinical evaluation of safety and efficacy of a new topical treatment for onychomycosis. J Drugs Dermatol. 2011; 10(10):1186-91.

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