Gel Injection for Ankle Arthritis

Osteoarthritis is the most common forms of arthritis. It occurs over time as the cartilage on the ends of bones wears down resulting with bone on bone grinding. Osteoarthritis worsens with time and patients often experience pain, stiffness, loss of flexibility, grinding sensation and formation of bone spurs. Currently there is no cure, and maintaining a healthy weight and healthy lifestyle, custom orthotics, proper shoe gear can help slow the progression.

Knee and ankle implants have a lifespan of 10 years and is often reserved as a last resort treatment option for the older population. An alternative treatment option is the use of hyaluronate injections. Hyaluronate sodium is a derivative of hyaluronic acid a natural substance that surrounds joints. The fluid acts as a lubricant and shock absorbent protecting joints. Over a course of four to eight weeks the use of hyaluronate injections may reduce the need for a joint replacement and help promote production of synovial fluid. In a diseased and arthritic joint, the production of hyaluronate decreases leading to mechanical destruction of the joint and pain. At the moment hyaluronate products are considered as off-labeled use in the ankle joint, but FDA approved for the knee joint.

There are six major trade name products: Euflexxa, Gel-one, Hyalgan, Supartz, Synvisc, Orthovisc. Most of these products are injected into the ankle joint 3 times total, one injection per week. Patients can return to normal daily activities but should postpone strenuous activities for 48 hours after each injection. The benefits typically last from 6-18 months or even longer. Even greater improvement has been observed when combined with arthroscopic debridement according to Carpenter and Motley in 2008.

For more information about viscosupplementation, make an appointment at (626) 517-0022 to see Dr. Sara Shirazi at Pasadena Orthopedics!

Ultrasound

---

General Diagnostic Ultrasound Q & A

Why do I need a general diagnostic ultrasound? Ultrasound technology utilizes very high-frequency sound waves, which bounce off structures inside your body, to produce images. This allows your specialist to see detailed images of your bones, connective tissues, muscles, and other components, with a simple, non - invasive, in-office imaging test. Your foot and ankle doctor may recommend a general diagnostic ultrasound to confirm or rule out any of the following conditions (among others):

• Achilles tendonitis

• Sprains and strains

• Plantar fasciitis

• Stress fracture

• Muscle tears

• Abscess

• Arthritis

• Bursitis

• Tumor

General diagnostic ultrasounds are also helpful for getting to the root of heel pain, which is one of the most common pain-causing issues podiatrists regularly treat.

What are the benefits of a general diagnostic ultrasound? Dr. Sara Shirazi proudly offers general diagnostic ultrasounds at Pasadena Orthopedics, Inc. The podiatry team regularly utilizes ultrasound imaging, because it:

• Provides instant images

• Requires no special preparation

• Doesn’t expose you to radiation

• Is more comfortable for the patient, cheaper, and faster than an MRI (and provides the same results)

Additionally, a general diagnostic ultrasound allows your podiatrist to observe the live movements of your inner structures. This is beneficial because if you only feel pain when you flex your foot, as an example, your podiatrist can have you flex during your ultrasound, so they can observe what’s happening and ensure they look at all surrounding structures.

What happens during a general diagnostic ultrasound? General diagnostic ultrasounds from Pasadena Orthopedics are routine components of pain or injury evaluations. After performing a thorough examination, checking your range of motion, and evaluating your pain, your dedicated podiatrist performs an ultrasound.

Dr. Shirazi applies a warm, clear gel-like substance to your skin and glides the ultrasound transducer — a small handheld tool — over your foot or ankle. They view images right on the screen and capture any photos or videos they may need to help with the diagnostic process.

Dr. Shirazi will talk with you about what she observes during the ultrasound and show you any areas of concern. In many cases, your doctor can diagnose you on the spot and talk with you about the best treatment options.

Pasadena Orthopedics provides on-site general diagnostic ultrasounds, so you can get fast results. Find out more by booking an appointment either online or over the phone today.

Call: 626-517-0022

Email: admin@pasadenaorthopedics.com

Website: www.pasadenaorthopedics.com

Laser Fungal Toe Nail Treatment

Featured on The Doctors show given its great success and FDA clearance in treating fungal nails!

Before & Afters

Frequently Asked Questions

Q: How does the PinPointeTM FootLaserTM work? A: The PinPointe FootLaser kills the fungus that lives in and under the nail. The laser light passes through the nail without causing damage to the nail or the surrounding skin. At the time of the procedure, the toenail will not become instantly clear— it takes time to grow out the healthy nail.

Q: What can I expect in the doctor’s office? A: The process begins with a consultation in which I will explain the procedure that is to be performed and any follow-up visits that may be required. If it is unclear from a visual examination if it is truly fungus, we can send a nail clipping to the lab to confirm. This is covered by insurance. You may have the consultation and treatment on the same day if desired.

Q: Is the procedure painful? A: Most patients feel no pain. Some may feel a warming sensation. An isolated few may feel a slight pinprick.

Q: Is there a recovery period? A: No. The treatment is a walk in/ walk out procedure with no down-time! You can do all normal activities after. Be sure to bring a pair of fresh socks for post-treatment. Sandals are also preferred.

Q: How long does the procedure take? A: The PinPointe FootLaser procedure typically takes about 30 minutes for all 10 toenails.

Q: Will the fungus grow back? A: One or two treatments kill the fungus for most people. However, there is a chance of reinfection because the fungus is present everywhere in the environment. I will recommend post-treatment care techniques to help reduce a recurrence of the infection. The analogy we like to use is... if you go to the dentist to fill a cavity, this does not mean you can stop brushing your teeth. Just like post-laser treatment, it does not mean you can stop eradicating fungus from the environment near you. Throw away old socks and slippers to prevent re-infection.

Q: When is it safe to paint my nails or have a pedicure following treatment? A: You can apply polish immediately after the treatment. It is important that you remove all nail polish and nail decorations the day before your treatment.

Q: Is the procedure covered by insurance? A: This procedure is considered aesthetic and therefore health insurance does not provide coverage. However, your HSA, Medical IRA, or Health Spending Account may sometimes be used to cover this procedure if they cover non-insurance covered services.

Q: What costs are covered in the treatment? A: We can begin with a free consultation to determine if you are a good candidate for this new therapy. If a lab test is needed to confirm the presence of the fungus, insurance will be billed. After an affirmative diagnosis, your nails will be debrided (trimmed and filed) and you will receive the treatment. A photo before and after may be included. Further follow-up visits and laser treatments may be scheduled if needed. Because it takes months for the new nail to grow out (6-12 months), periodic visits to check on your progress are scheduled. For very severe infections, additional sessions may be recommended. You will also be given a Post-Laser Treatment Care Kit containing products that will enhance the effectiveness of the treatment and be personalized for you as determined by Dr. Shirazi. We take this diagnosis seriously and will work diligently to help you the entire way to a clear nail!

Q: How long has the PinPointe FootLaser been in use? A: Clinical studies began in November 2007.

Q: Is the PinPointe FootLaser FDA cleared? A: Yes, the device has received FDA clearance for treatment of toenail fungus.

Q: Who developed the PinPointe FootLaser procedure? A: Leading scientists and medical professionals working together for 20 years with funding provided by the National Institutes of Health (NIH) developed the technology used in the patented PinPointe FootLaser.