The Top Ten Innovations In Podiatry

Brian McCurdy, Senior Editor

   BioCartilage has several advantages relative to other biologic adjuncts such as platelet rich plasma, concentrated bone marrow aspiration or particulate juvenile cartilage for augmenting repair and replacement of osteochondral lesions of the talus, according to Dr. Catanzariti, the Director of Residency Training at the Western Pennsylvania Hospital in Pittsburgh. He says the small particle size improves BioCartilage’s injectable nature after one mixes it with an autologous blood solution, allowing easier delivery to the defect site. In addition, Dr. Catanzariti says the small particle size also increases the surface area, providing attachment sites for the patient’s bone marrow cells. Furthermore, the price of BioCartilage is approximately $770 per 1 cc, which Dr. Catanzariti notes is relatively inexpensive in comparison to other biologic adjuncts that surgeons use to treat osteochondral lesions of the talus.

Zimmer® Trabecular Metal Total Ankle (Zimmer). An emerging total ankle implant utilizes a lateral transfibular approach that may help reduce the incidence of postoperative infection. The manufacturer Zimmer notes its Zimmer Trabecular Metal Total Ankle’s lateral approach avoids stressing neurovascular structures and disrupting angiosomes. The company says the lateral approach allows full visualization of the anatomic center of rotation.

   Lawrence DiDomenico, DPM, FACFAS, notes that the Trabecular Metal Total Ankle is the only FDA-approved ankle implant that offers a lateral approach. Most of the patients he sees for possible ankle replacement surgery are post-traumatic. Dr. DiDomenico says some of these patients have had either an open fracture or previous surgery, leading to soft tissue complications.

   “In scenarios such as this, a lateral approach is very desirable,” says Dr. DiDomenico, the Section Chief of the Department of Podiatry at St. Elizabeth Hospital in Youngstown, Ohio.

   Zimmer adds that the implant reproduces the ankle’s natural flexibility and motion, and features Prolong® Highly Crosslinked Polyethylene. The semi-constrained Zimmer device provides joint mobility by restoring alignment, reducing pain and preserving the flexion/extension movement within the ankle joint, according to the company. The three implant components include a talar component, tibial base component and modular tibial articular surface, according to Zimmer. It also cites the benefit of six implant sizes in anatomic configurations with variable radii of curvature in proportion to implant size as in the natural ankle.

   Dr. DiDomenico says with the Trabecular Metal Total Ankle, joint resection is similar to a normal joint. The bone loss is relatively small and he notes the implant offers a highly cross-linked polyethylene, which has a fivefold decrease in wear in comparison to the use of conventional polyethylene.

A Closer Look At Emerging Antifungals

Luzu® (Valeant Pharmaceuticals). Podiatrists now have a new topical option for the treatment of tinea pedis.

   Tracey Vlahovic, DPM, cites luliconazole cream 1% (Luzu) as an innovative topical azole. A principal investigator on the phase 3 clinical trial, she notes the product has garnered FDA approval for interdigital tinea pedis for once-a-day application as part of a two-week treatment regimen. Dr. Vlahovic points out that Luzu recently had its launch in the United States after being available for several years in Japan.

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