EOTTS Exceeds the Requirements of Being Evidence-based

EOTTS functions better than external modalities and without the risks and complications associated with other more aggressive surgical procedures.
By: GraMedica
Dr. Michael E. Graham
Dr. Michael E. Graham
MACOMB, Mich. - Jan. 30, 2018 - PRLog -- There has been a struggle over the past few decades to gain acceptance by the insurance industry to reimburse surgeons and facilities for internally re-aligning and stabilizing one of the most important weight-bearing joints, the talotarsal joint (TTJ). Their primary excuse for not paying, "covering" this life-changing solution, is the lack of scientific evidence. They label extra-osseous talotarsal stabilization (EOTTS) as "experimental or investigational." How long they can continue to call it that remains a mystery. This extremely crucial treatment option, EOTTS, serves as an important piece of the puzzle to maintain balance, stability, and alignment within the foot and proximal musculoskeletal structures.

The TTJ, acetabulum pedis, is the foundation joint of the body. It is responsible for handling the vertical forcesfrom above, and the weight-bearing surface from below. Approximately, half of those forces should act on the posterior talocalcaneal facet and the remaining forces act on the facets anterior to the sinus tarsi. A stable and aligned TTJ creates an efficient transfer of weight-bearing forces and minimal amount of muscle activity.

  A pathologic condition exists where the weight-bearing alignment and stability of the TTJ is lost. TTJ instability leads to mis-alignment within the TTJ, resulting in an excessive medial, anterior, and/or plantarflexion of the talus with the calcaneus and navicular. The articular facets of the talus on the calcaneus and navicular are no longer in constant congruent contact. This orthopedic abnormality is referred to as a dislocation.

  The primary goal of treatment is to maintain the stability and alignment of the articular facets of the TTJ. Accomplishing this goal while continuing to maintain a normal range of TTJ motion has been the preferred method over the complete elimination of TTJ range of motion. It is for that reason specifically that orthopedic innovators have tirelessly dedicated their efforts to achieve this result. External modalities may be able to provide short-term relief to secondary symptoms attributed to RTTJD. However, the reality is that there is no evidence that external treatments can succeed at re-aligning and maintaining the articular facets of the TTJ. Evidence has proven this fact.

  EOTTS is a time-tested, evidenced-based, soft tissue procedure where an orthopedic stent is inserted into the sinus tarsi.There are more than a dozen FDA-cleared devices being routinely used within the United States. In fact, these sinus tarsi stents are regularly recommended to patients by both orthopedic and podiatric surgeons globally. Their use is advocated at orthopedic and podiatric medical conferences world-wide. The use of sinus tarsi implants has been positively documented within chapters of many well-known orthopedic and podiatric textbooks. The advocacy for the EOTTS procedure has continued to increase since its first introduction decades ago.

  There is evidence that the EOTTS procedure maintains the stability and alignment of the TTJ clinically and radiographically. There have been multiple published studies showing reduction/normalization of pre-EOTTS pathologic findings. There is also evidence that the EOTTS procedure normalizes the range of motion of the TTJ simply by realigning and stabilizing the TTJ. A similar accepted treatment that would be a covered benefit, without question, is a subtalar joint arthrodesis. This is a functional amputation of the TTJ. The short- and long-term complications of arthrodesis are well established. A key advantage of EOTTS is that unlike arthrodesis, it still allows the normal TTJ range of motion to take place. It is for this reason that EOTTS should be considered a conservative surgical option over aggressive joint destructive procedures.

  Further evidence shows that the EOTTS procedure normalizes the joint forces acting on the tarsal mechanism. There is no data to show similar results with other "accepted" forms of treatment, i.e., lateral column lengthening, medial displacement,calcaneal osteotomy, talonavicular arthrodesis, or subtalar arthrodesis.Ligament strain is decreased, which stops the muscle-tendon compensations. EOTTS functions better than external modalities and without the risks and complications associated with other more aggressive surgical procedures.

  EOTTS is a minimally invasive procedure that exceeds the requirements of being evidence-based. The ability of a surgeon to internally realign and stabilize the TTJ, while still allowing a normal range of motion, is essential in the treatment of many lower extremity pathologies. EOTTS normalizes the forces acting within the foot structure, and instantly decreases forces acting on the bones, joints, tendons, ligaments, and neurovascular structures of the foot. Because the ankle joint is realigned, there are positive effects to the knees, hips, pelvis, and spine. This procedure is reversible. It can be used in conjunction with both external measures and other surgical procedures. This soft tissue procedure can and is commonly performed on both children and adults. There are many reasons why EOTTS devices have been approved and are being performed in more than 70 countries. Patients who have had the EOTTS procedure have been able to increase their activity levels, increase their metabolism, decrease their weight, and improve their blood sugar levels and blood pressure.

To learn more about EOTTS visit http://www.hyprocure.com

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Tags:Eotts, Orthopedic
Location:Macomb - Michigan - United States
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Page Updated Last on: Jan 30, 2018

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