does external fixator improve cheilectomy results?

I found you on the internet and would be most grateful if you would give a comment to help my decision. I am a 37 year old active male with moderate arthritis in the joint below my big toe after an injury playin gbasketball 3years ago. I still have some "joint space" and the cartilage has not completely deteriorated, although the ostephyte at the 1st methed has increased i nsize over a year. My podiatrist recommended a cheilectomy with an external joint fixative device during recovery. My understanding is that the fixative device and letting some bleeding occur into the joint is supposed to create scar tissue that acts like cartilage. Evidently, the use of the external device has only recently been approved but my podiatrist believes that this innovation goes a long way in delaying an eventual joint fusion.

Sounded great to me except that two orthopedic surgeons said that there was no evidence that this will improve results. One said that the procedure might buy me a year or two in the degeneration of the joint but that was it. Neither recommended the surgery, they said just treat symptoms until it gets too bad and then consider a fusion.

One surgeoen said that the use of these devices and this technique with knees has proven far less effective than originally thought. He said we simply have not found any way to reporduce the appropriate cartilage and everything else just breaks down.

My question is about the efficacy of the procedure. Are you familiar with it? Does the use of the external fixitive device which immobilizes and slightly strethces the joint while healing make a big difference? Is there evidence that this change in the procedure substantively changes the likelihood of returning health to the joint for any length of time? I would be most grateful if you could comment. I understand that you cannot give me a medical opinion without an exam, however if you could give me an opinion about the procedure itself that would be most helpful!

Posted By Steve Kogan on November 22, 2002 at 13:04:11:

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