After 14 years of foot and ankle healthcare I’ve seen trends, techniques, and technology come and go. Some innovations are ground breaking, which means more success and a faster recovery. Believe me, when it comes to recovery, time is of the essence. From innovative surgical techniques, like minimally invasive surgery, to ways to increase blood flow, such as injections and shockwave, recovery is faster than ever before. While I only treat below the knee, I will often use diagnostic tools to see how other parts of the body could be effecting your feet and ultimately your recovery. We have in-house equipment like Gait Analysis (simply put, how you walk), Digital X-ray, Diagnostic Ultrasound etc. The feet are a part of complex whole body processes, therefore respect for the system is essential for a full recovery.
We can take a look at an example of this to further illustrate. A 25 year old patient and an 85 year old patient come in for the same problem. The treatment might be exactly the same, but the recovery time would naturally be drastically different. By using minimally invasive techniques and optimizing the body to fuel healing, the 85 year old will have a much faster and safer rate of recovery, similar to the 25 year old.
During residency at the University of Louisville, a Level 1 Trauma Center, I spent 6 months on rotations involving plastic surgery, orthopedics, vascular surgery and primary care management from pediatrics to geriatrics. Working on different systems in the body gives tremendous insight on how the body heals. In one patient I could remove sutures after five days on a face laceration. However, when the same size laceration happened on the foot, it could take 21 days to heal. The ultimate conclusion that was made was that blood flow was the key to timely healing. So if you think back to our 25 year old patient with excellent blood flow, verse our 85 year old patient whose blood flow isn’t as robust, the recovery would be slower.
But back to the technological advances…now even an 85 year old may have a better chance of a faster recovery…..
There are known areas of the body that take longer to heal, like ACL repair, shoulder, and parts of foot and ankle. The achilles, for example, is the largest tendon in the body with the worst blood flow. The robust achilles tendon is fed by tiny blood vessels in a thin membrane known as the paratenon. Traditional achilles repairs involved non-weight bearing for 6-12 weeks, and took 12-15 months before people were fully recovered. The large incisions would often have delayed healing, limiting recovery. Then what seemed to be a breakthrough happened, minimal invasive surgery and injections/shockwave/laser techniques that increase blood flow for full ruptured achilles. The incision went from 9 inches to 1 inch, thus dramatically improving skin healing. Dr. Barnett quickly adapted this technique to offer the most cutting edge technique available. Now, a once risky surgery now is dramatically less risk. Just ask Aaron Rodgers, who himself just had a minimal invasive achilles repair!
The newest innovation is now a minimal invasive Haglunds deformity. This is where there is a large bone spur on the back of the heel that rubs on shoes and is very painful to walk. The old school methods was a 5 inch incision, and delayed healing and nonweightbearing kept people off the foot for 6-10 weeks. The new procedure allows weight bearing at a week and has an incision 1/4 inch (x4). This allows the same correction and result with a much faster recovery. Dr. Barnett is the first person in Pinellas county to offer this highly effective procedure to his patients.
The overall findings are that minimal incisions & increased blood flow can make a huge impact on overall recovery. This idea spans all of foot surgery, whether talking bunions, charcot reconstruction, or trauma. Advanced techniques are making recovery easier and less debilitating. Walking aids (scooters, crutches or wheelchairs) are used for shorter time periods, showering can happen sooner, and simple getting back to being yourself is now faster. Technologies in Dr. Barnett’s office aid in a faster & fuller recovery.
The moral of the recovery journey is that foot surgery can be slow compared to the rest of the body, but Dr. Barnett uses technology and innovation for faster healing and ultimately happier patients.