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Started By
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Podiatrist or Ortho Surgeon for surgery?
Posted on 2/24/17 at 10:22 am
Posted on 2/24/17 at 10:22 am
I've got to have a procedure on my foot and am having a hard time deciding who to let do it. There are tons of articles online and none of them offer much help. Have any of you had any good or bad experiences with either? For surgery. Anybody had give a cortisone shot and order an MRI.
5
Posted on 2/24/17 at 10:30 am to Hot Carl
Which procedure? Who's done it more? Who does your PCP or sports med doc recommend?
Posted on 2/24/17 at 10:33 am to Hot Carl
If it is something like a Buionectomy then definitely a Podiatrist. They do them all the time and are very good. If is something more extensive like an Achilles tendon then I would pick an Ortho doctor
Posted on 2/24/17 at 10:36 am to Hot Carl
As a podiatrist I'm biased, but it honestly depends on the procedure. What are you having done?
It also depends on which podiatrist and which ortho.
It also depends on which podiatrist and which ortho.
Posted on 2/24/17 at 10:38 am to GEAUXT
Also, if you do go to an ortho make sure and go to one who did a foot and ankle fellowship.
The vast majority of orthos see relatively small volumes of foot and ankle pathology during residency other than ankle fractures.
The vast majority of orthos see relatively small volumes of foot and ankle pathology during residency other than ankle fractures.
Posted on 2/24/17 at 10:40 am to GEAUXT
It's probably gonna be the Weil osteotomy. Have dealt with 2nd MTP synovitis for 6 years now. Haven't been able to run. Have had probably 15 cortisone shots on both the top and bottom of my foot. Took my daughter walking a few days ago and it is swollen up like a tomato. Can't put any weight on it.
Posted on 2/24/17 at 10:42 am to GEAUXT
quote:
Also, if you do go to an ortho make sure and go to one who did a foot and ankle fellowship.
This is a must!
Posted on 2/24/17 at 10:46 am to Hot Carl
For most any forefoot procedure a podiatrist will most likely have more surgical experience. Again, not saying orthos are bad or can't do the procedure as it is not a difficult or special one.
I will say that the weil is a very popular procedure that yields overall good results. However, most foot and ankle surgeons are in a constant search for a better one. Compared with a lot of other things we do, the weil has a lower patient satisfaction due to a small lack of predictability post operatively.
The problem with lots of cortisone shots for capsulitis like you have is that it can weaken the capsule and cause more problems. There's a good chance they'll want to/try to do a repair of the capsule as well as shortening the bone.
I will say that the weil is a very popular procedure that yields overall good results. However, most foot and ankle surgeons are in a constant search for a better one. Compared with a lot of other things we do, the weil has a lower patient satisfaction due to a small lack of predictability post operatively.
The problem with lots of cortisone shots for capsulitis like you have is that it can weaken the capsule and cause more problems. There's a good chance they'll want to/try to do a repair of the capsule as well as shortening the bone.
Posted on 2/24/17 at 10:52 am to GEAUXT
quote:
As a podiatrist
Do you have an opinion on stem cell therapy to treat fibular sesamoid avascular necrosis?
Posted on 2/24/17 at 10:56 am to GEAUXT
My step-dad is a Podiatrist and I 2nd this motion.
Posted on 2/24/17 at 10:59 am to LZ83
quote:
Podiatrist
quote:
step-dad
Well done sir
Posted on 2/24/17 at 11:00 am to little billy
quote:
stem cell therapy to treat fibular sesamoid avascular necrosis?
Stem cell treatments, PRP, and the like are all the rage right now. The research is still fairly limited, and what is out there certainly doesn't make it out to be a cure all.
My biggest problem with a lot of these treatments is that they are quite expensive, and they are not covered by insurance. That means you are paying out of pocket for a treatment without the best supporting evidence.
I'm not saying it's voodoo, as I think it has some promise in the paper situations. However, sesamoid AVN I would be very hesitant to shell out a bunch of my own money.
Posted on 2/24/17 at 11:02 am to GEAUXT
Thank you, sir. Can you estimate the percentage that sesamoid AVN can be treated successfully without surgery with orthotics and such?
Posted on 2/24/17 at 11:22 am to little billy
Honestly, sesamoid AVN is very uncommon. The usual conservative treatment is anti-inflammatories and off loading (orthotics)
I don't have a percentage off the top of my head as it is not common to see, however I'd still say over 50% will improve without surgery.
Surgical correction involves removing a portion or all of the sesamoid.
I don't have a percentage off the top of my head as it is not common to see, however I'd still say over 50% will improve without surgery.
Surgical correction involves removing a portion or all of the sesamoid.
Posted on 2/24/17 at 11:26 am to GEAUXT
I am very appreciative for your feedback.
Posted on 2/24/17 at 12:38 pm to GEAUXT
Knowing what you know, would you have the Weil on yourself?
Posted on 2/24/17 at 12:42 pm to Hot Carl
I would go with an ortho that specializes in foot/ankle
in BR I would go with
LaLonde
Johnson-Riche'
Blanchard
in that order, but all 3 are great
in BR I would go with
LaLonde
Johnson-Riche'
Blanchard
in that order, but all 3 are great
Posted on 2/24/17 at 12:52 pm to Hot Carl
quote:
would you have the Weil on yourself?
Yes, I would do it. I would just go into it knowing that there is a potential for it not to turn out perfect.
Posted on 2/24/17 at 12:54 pm to Tigerpaw123
quote:
I would go with an ortho that specializes in foot/ankle
Not that I disagree, but why?
quote:
Johnson-Riche'
I like her and she's responsible for 6-7 of my cortisone shots--Ive seen her for 3 or 4 years. But she doesn't seem to understand just how much this is affecting my quality of life. She basically says "it sucks, but try some better shoes, so some calf stretches and come see me again in 3 months for another cortisone shot."
I'm still into 30s(barely), and I'm not ready to just concede not being able to do the things this has prevented me from doing the last 6 years.
Posted on 2/24/17 at 1:01 pm to Hot Carl
quote:
responsible for 6-7 of my cortisone shots
Like I said earlier, the problem with continually injecting cortisone is that it will eventually weaken the tissues worsening the problem. If she (or someone else) suggested a Weil that means you have a long metatarsal. That causes a biomechanical imbalance, and as long as that is present your going to be predisposed to problems.
If you were interested in a second opinion in the BR area I would recommend one of the Halls. They are father and son podiatrists. They are the foot & ankle guys for the Bone & Joint Clinic in BR. They're both very well trained.
While no doctor should rush someone to surgery, I agree with you that in your 30's it is not something you should just suck up and deal with.
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