Injections and Other Procedures

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  • CROW - Charcot Restraint Orthotic Walker

    The Charcot Restraint Orthotic Walker, or CROW, is a rigid boot designed to accommodate and support a foot with Charcot neuroarthropathy (CN).

    CROW consists of a fully enclosed ankle/foot orthotic with a rocker-bottom sole. It is a common treatment used to minimize further deformity and prevent ulcer development after acute CN has calmed down.

    CN occurs when bones and joints in the foot fracture, break up or pop out of place with minimal or no known direct injury. In the United States, this deformity most commonly occurs in people with diabetes. The foot first enters an acute stage of swelling, warmth and redness, that can be mistaken for an infection. Broken bones and dislocations can occur, causing severe deformities of the foot and ankle. Some patients develop pain or ulcers when the affected foot becomes deformed. CN can affect the other foot or happen again in the same foot. The foot does not regain its normal shape.

  • Distraction Arthroplasty

    Distraction arthroplasty is a distraction (stretching out) of the ankle joint. The ankle is held in this distracted position for a period of time. This technique is used to unload the ankle joint and allow healing of the damaged joint. It may be recommended for a patient who has ankle arthritis.

    The major goal of this treatment is healing of damaged tissue that occurs from arthritis. Distracting and unloading the ankle joint, along with the use of range of motion activity, is believed to help restore some of the damaged tissue in the ankle. With this restoration, a patient may be able to avoid or delay a more invasive procedure such as an ankle fusion or total ankle replacement. This allows patients to maintain motion of the ankle joint, which would be lost with an ankle fusion, and potentially avoid activity restrictions that may be necessary after an ankle replacement.

  • Extracorporeal Shock Wave Therapy

    Shock wave therapy is a non-invasive method that uses pressure waves to treat various musculoskeletal conditions. High-energy acoustic waves (shock waves) deliver a mechanical force to the body’s tissues.

  • Joint Injections

    A joint injection is a procedure your doctor uses to introduce medication into a joint. The injection is done under sterile conditions using a syringe and needle.

    The goals of a joint injection are to relieve pain and improve joint function. Your foot and ankle orthopaedic specialist also may confirm your diagnosis when giving a joint injection.

  • Joint Injections

    A joint injection is a procedure your doctor uses to introduce medication into a joint. The injection is done under sterile conditions using a syringe and needle.

    The goals of a joint injection are to relieve pain and improve joint function. Your foot and ankle orthopaedic specialist also may confirm your diagnosis when giving a joint injection.

  • Orthotics

    Orthotics, also called orthoses, are devices that are worn to relieve pain associated with foot and ankle deformities and help prevent or delay surgery. Most people think of shoe inserts or arch supports when they hear the word orthotics, but they can include devices such as foot pads, shoe inserts, ankle braces, and similar items. Treatment often can begin with less expensive off-the-shelf orthotics and progress to custom orthotics if the symptoms and diagnosis require it.

  • Orthotics

    Orthotics, also called orthoses, are devices that are worn to relieve pain associated with foot and ankle deformities and help prevent or delay surgery. Most people think of shoe inserts or arch supports when they hear the word orthotics, but they can include devices such as foot pads, shoe inserts, ankle braces, and similar items. Treatment often can begin with less expensive off-the-shelf orthotics and progress to custom orthotics if the symptoms and diagnosis require it.

  • Plantar Fascia Injection

    The plantar fascia (PF) is a thick band of tissue that connects your heel bone to your toes. It helps support the overall shape of your foot, especially when standing, and helps with shock absorption. Irritation and scarring of the plantar fascia, known as plantar fasciitis, is one of the most common causes of heel pain.

    Ten percent of people have pain in the bottom of the heel at some point in their life. The most common cause is plantar fasciitis, which can result from overactivity, improper shoes, flat feet or excessive weight on the feet.

  • Platelet-Rich Plasma Injections

    Platelets are small cells in the blood that help form clots to stop bleeding. Platelet-rich plasma (PRP) is a patient’s own concentrated platelets. PRP contains a large number of growth factors. These growth factors are thought to stimulate healing.

    When PRP is injected, it can aid the body’s natural healing of injuries. The goal is not only to relieve symptoms but also to create actual healing. In some cases, PRP injections may reduce the need for medication and/or surgery.

    PRP injections have been used to treat tendon, ligament, cartilage and bone injuries, as well as arthritis. Around the foot and ankle PRP is used for treatment of tendon and ligament injuries such as plantar fasciitis, Achilles tendon and ankle ligament injuries.

    PRP injections are not recommended for the treatment of infections or cancer.

  • Proximal Tibial Bone Graft

    Bone grafts may be needed for various orthopaedic surgeries of the foot and ankle. Bone grafts provide bony support and/or fill in areas where bone is missing. Bone grafts are either taken from the patient (autograft), or taken from a bone donor (allograft). The best bone graft provides enough bone and healing with minimal problems for the patient.

    Proximal tibial bone graft (PTBG) is a type of autograft. The proximal tibia is the upper portion of the leg or shin bone that is just below the knee joint. Getting bone graft from this body part usually is less painful than from other areas like the pelvis.

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