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A Randomized Clinical Trial To Compare The Effect Of Non Operative Treatment With And Without Autologous Conditioned Plasma (Acp) On Healing And Function In Patients With Achilles Tendon Ruptures, Tyler M. Pratt 2015 The University of Western Ontario

A Randomized Clinical Trial To Compare The Effect Of Non Operative Treatment With And Without Autologous Conditioned Plasma (Acp) On Healing And Function In Patients With Achilles Tendon Ruptures, Tyler M. Pratt

Electronic Thesis and Dissertation Repository

The purpose of this study was to determine whether there is evidence to support conducting a larger randomized control trial (RCT) to compare the non-operative treatment of Achilles tendon (AT) ruptures with or without Autologous Conditioned Plasma (ACP®). Twenty-four patients were randomized to receive an ACP® or saline injection within seven days and again at two weeks post-rupture. Tendon healing was longitudinally evaluated using ultrasound (US) and magnetic resonance imaging (MRI). Functional and patient-reported quality of life measures were also assessed. A small sample size limited our ability to detect statistically significant differences. The mean rankings of healing were slightly …


Blood, Brain And Now Bone – Learning More About An Often Overlooked Pathogen, Linda Lesky, Julianne Camba, Sarah De Los Santos, Alexander Fortenko, Talal Alzahrani 2015 George Washington University

Blood, Brain And Now Bone – Learning More About An Often Overlooked Pathogen, Linda Lesky, Julianne Camba, Sarah De Los Santos, Alexander Fortenko, Talal Alzahrani

GW Research Days 2015

INTRODUCTION:

Arcanobacterium haemolyticum (previously Corynebacterium haemolyticum), a facultative anaerobe, Gram positive rod was first isolated from United States servicemen and indigenous populations of the South Pacific in 1946. Early reported cases detailed A. haemolyticum as a causative pathogen for exudative pharyngitis (most commonly in adolescents) and cutaneous infections. Osteomyelitis caused by A. haemolyticum has been described in less than five cases in the literature. Here, we describe our experience in diagnosing patient with osteomyelitis caused by A. haemolyticum.

CASE REPORT:

A 30-year-old man with a history of peripheral neuropathy, diabetic foot ulcers, methicillin-resistant S. aureus osteomyelitis and amputation of the …


Local And Distant Pedicle Flaps For Soft Tissue Reconstruction Of The Diabetic Foot: A Stepwise Approach With The Use Of External Fixation, T. Zgonis, John Stapleton, I. Papakostas 2015 Lehigh Valley Health Network

Local And Distant Pedicle Flaps For Soft Tissue Reconstruction Of The Diabetic Foot: A Stepwise Approach With The Use Of External Fixation, T. Zgonis, John Stapleton, I. Papakostas

John J Stapleton DPM, FACFAS

No abstract provided.


Stepwise Approach To Static Circular External Fixation, John Stapleton, V. Polyzois, T. Zgonis 2015 Lehigh Valley Health Network

Stepwise Approach To Static Circular External Fixation, John Stapleton, V. Polyzois, T. Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Use Of Circular External Fixation For Combined Subtalar Joint Fusion And Ankle Distraction., Thomas Zgonis, John Stapleton, Thomas S Roukis 2015 University of Texas Health Science - San Antonio

Use Of Circular External Fixation For Combined Subtalar Joint Fusion And Ankle Distraction., Thomas Zgonis, John Stapleton, Thomas S Roukis

John J Stapleton DPM, FACFAS

The authors discuss a novel technique not previously published that incorporates a subtalar joint arthrodesis with an ankle joint arthrodiastasis as an alternative to a tibiotalocalcaneal arthrodesis. Young and active patients who experience refractory pain and stiffness to the rearfoot and ankle secondary to combined severe subtalar and ankle arthrosis are suitable candidates for this surgical procedure. This new approach is based on sound principles in the treatment of severe arthrosis affecting the ankle and subtalar joint. The authors are currently prospectively reviewing their surgical experience with this procedure and believe that it provides an alternative option for the patient, …


Surgical Management Of Diabetic Foot And Ankle Infections., Claire M Capobianco, John Stapleton, Thomas Zgonis 2015 University of Texas Health Science - San Antonio

Surgical Management Of Diabetic Foot And Ankle Infections., Claire M Capobianco, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

Delayed treatment of any diabetic foot infection can lead to a limb- or life-threatening scenario. Urgent and/or emergent surgery may be necessary in the early diagnosis of a severe diabetic foot infection that is followed by staged reconstructive procedures. This article provides the reader with a thorough understanding of the surgical management of severe diabetic foot infections and describes and guides treatment based on a rational schematic approach that identifies the anatomic location of the diabetic foot infection.


Innovative Techniques In Preventing And Salvaging Neurovascular Pedicle Flaps In Reconstructive Foot And Ankle Surgery., Thomas Zgonis, John Stapleton 2015 University of Texas Health Science - San Antonio

Innovative Techniques In Preventing And Salvaging Neurovascular Pedicle Flaps In Reconstructive Foot And Ankle Surgery., Thomas Zgonis, John Stapleton

John J Stapleton DPM, FACFAS

Pedicle flaps to cover soft tissue defects of the foot, ankle, and lower extremity are invaluable. However, venous congestion and flap necrosis, a common complication, poses greater morbidity to the patient as few remaining options for attempted limb salvage remain. The authors discuss how to prevent flap failure by allowing close observation and strict offloading of the pedicle flap through current external fixation designs. This article also discusses the role of medicinal leeches in reestablishing blood flow through the pedicle flap to prevent tissue necrosis. In addition, the use of hydrosurgery as an innovative technique offers the surgeon another option …


Stepwise Approach To Ankle/Pilon Trauma And External Fixation, John Stapleton, V. Polyzois, T. Zgonis 2015 Lehigh Valley Health Network

Stepwise Approach To Ankle/Pilon Trauma And External Fixation, John Stapleton, V. Polyzois, T. Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Negative-Pressure Wound Therapy In The Management Of Diabetic Charcot Foot And Ankle Wounds., Crystal L Ramanujam, John Stapleton, Thomas Zgonis 2015 University of Texas Health Science - San Antonio

Negative-Pressure Wound Therapy In The Management Of Diabetic Charcot Foot And Ankle Wounds., Crystal L Ramanujam, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

As the prevalence of diabetes mellitus continues to rise, innovative medical and surgical treatment options have increased dramatically to address diabetic-related foot and ankle complications. Among the most challenging clinical case scenarios is Charcot neuroarthropathy associated with soft tissue loss and/or osteomyelitis. In this review article, the authors present a review of the most common utilizations of negative-pressure wound therapy as an adjunctive therapy or combined with plastic surgery as it relates to the surgical management of diabetic Charcot foot and ankle wounds.


The Diabetic Foot, C. Ramanujam, John Stapleton, T. Zgonis 2015 Lehigh Valley Health Network

The Diabetic Foot, C. Ramanujam, John Stapleton, T. Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Revisional And Reconstructive Surgery Of The Diabetic Foot And Ankle, T. Zgonis, John Stapleton, V. Polyzois, E. Sella 2015 Lehigh Valley Health Network

Revisional And Reconstructive Surgery Of The Diabetic Foot And Ankle, T. Zgonis, John Stapleton, V. Polyzois, E. Sella

John J Stapleton DPM, FACFAS

No abstract provided.


Internal And External Fixation Approaches To The Surgical Management Of Calcaneal Fractures., John Stapleton, Gennady Kolodenker, Thomas Zgonis 2015 Lehigh Valley Health Network

Internal And External Fixation Approaches To The Surgical Management Of Calcaneal Fractures., John Stapleton, Gennady Kolodenker, Thomas Zgonis

John J Stapleton DPM, FACFAS

Calcaneal fractures are one of the most difficult fractures to surgically manage and often require a steep learning curve to achieve consistent results. They usually occur in young individuals with labor intensive occupations and are associated with major complications. Conservative treatment of intraarticular calcaneal fractures with displacement often results in significant deformity, bone loss, and posttraumatic arthrosis. Optimally, an open approach is required in most cases to achieve anatomic reduction and successful long-term outcomes.


Surgical Management Of Diabetic Charcot Foot And Ankle Deformities, John Stapleton, Zacharia Facaros, Vasilios Polyzois, Thomas Zgonis 2015 Lehigh Valley Health Network

Surgical Management Of Diabetic Charcot Foot And Ankle Deformities, John Stapleton, Zacharia Facaros, Vasilios Polyzois, Thomas Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Corrective Midfoot Osteotomies., John Stapleton, Lawrence DiDomenico, Thomas Zgonis 2015 Lehigh Valley Health Network

Corrective Midfoot Osteotomies., John Stapleton, Lawrence Didomenico, Thomas Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Soft Tissue Reconstruction Pyramid In The Diabetic Foot., Claire M Capobianco, John Stapleton, Thomas Zgonis 2015 University of Texas Health Science - San Antonio

Soft Tissue Reconstruction Pyramid In The Diabetic Foot., Claire M Capobianco, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

Foot complications and ulceration are well-known sequelae to uncontrolled diabetes. Patients with chronic foot ulcers or wounds resulting from surgical debridement of deep-space infections are at continued risk for development of osteomyelitis and potential amputation. Moreover, these wounds often necessitate multiple outpatient clinic visits, daily dressing care, and prolonged periods of non-weight bearing, all of which have been shown to adversely affect the patient's quality of life. After a prudent period of wound-healing response, the authors believe that early and aggressive soft tissue reconstruction is in the patient's best interest and is crucial for resolution of the chronic nonhealing wound. …


Advanced Plastic Surgery Techniques For Soft Tissue Coverage Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Thomas S Roukis 2015 University of Texas Health Science - San Antonio

Advanced Plastic Surgery Techniques For Soft Tissue Coverage Of The Diabetic Foot., Thomas Zgonis, John Stapleton, Thomas S Roukis

John J Stapleton DPM, FACFAS

Obtaining stable, durable, and functional wound closure of a diabetic foot wound or open pedal amputation through plastic surgical techniques is essential to limit the potential for repeated ulceration, infection, and "supra-pedal" amputation. Myriad conservative and surgical techniques can be used to obtain wound closure. The authors discuss their approach and present operative pearls for their most commonly employed plastic surgical techniques to provide adequate soft tissue coverage of diabetic foot wounds. Emphasis is placed on the techniques necessary to perform these procedures and the surgical thought process involved in closing diabetic foot wounds.


Stepwise Approach To Forefoot Trauma And External Fixation, C. Capobianco, John Stapleton, T. Zgonis 2015 Lehigh Valley Health Network

Stepwise Approach To Forefoot Trauma And External Fixation, C. Capobianco, John Stapleton, T. Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Stepwise Approach To Midfoot/ Hindfoot Trauma And External Fixation, John Stapleton, V. Polyzois, T. Zgonis 2015 Lehigh Valley Health Network

Stepwise Approach To Midfoot/ Hindfoot Trauma And External Fixation, John Stapleton, V. Polyzois, T. Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Stepwise Approach To Adult And Pediatric Foot And Ankle Malunions/Nonunions And External Fixation, A. Cherkashin, M. Samchukov, J. Birch, John Stapleton, T. Zgonis 2015 Lehigh Valley Health Network

Stepwise Approach To Adult And Pediatric Foot And Ankle Malunions/Nonunions And External Fixation, A. Cherkashin, M. Samchukov, J. Birch, John Stapleton, T. Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


Current Concepts With External Fixation And The Charcot Foot, Crystal Ramanujam, John Stapleton, Thomas Zgonis 2015 Lehigh Valley Health Network

Current Concepts With External Fixation And The Charcot Foot, Crystal Ramanujam, John Stapleton, Thomas Zgonis

John J Stapleton DPM, FACFAS

No abstract provided.


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