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Dr. Timothy Young
 - a Board Certified Foot Surgeon Discusses Sesamoid Problems –  Part 1

Sesamoid problems are fairly common in the feet.  There are 2 sesamoid bones at the base of the great toe joint.  These are small bones about the size of a pea.  A larger sesamoid bone is the patellar kneecap.  By definition, a sesamoid bone has a muscle and then the sesamoid bone which crosses the joint, and then there is a tendon from the sesamoid bone crossing over the joint to attach to  the other side of the joint.  In the knee, there is the quadricep muscle which attaches to the patella or kneecap, and then the knee Is attached to the tibia by the patellar tendon.  

This muscle sesamoid bone and tendon complex crosses the joint and gives leverage and protection to the mechanical function of the joint.  In the foot, the sesamoid bone can be very vulnerable.  As soon as the heel comes up off the ground during gait and other full weightbearing activities, the load and weight is transferred to the forefoot and up to have to wait or more will be transmitted through the sesamoid bones into the head of the first metatarsal.  Therefore, any running activity our other sports such as dance puts a heavy load on the sesamoid bones.  These are common activities with the sesamoid bones can be injured or damaged.

If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online

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Dr. Timothy Young
 a board certified foot surgeon, discusses treating midfoot arthritis.
Midfoot arthritis is a common problem, especially as we all get older. Very commonly it the second metatarsal–cuneiform joint Is involved. Often additional adjacent joints can be involved. There are a number of treatments for this condition that can range from prescription orthotics, rocker style shoes, calf stretching and nutritional supplements. Additional treatment options include injections of synthetic joint lubricant into these joints.

This can be a difficult access or find the correct entry point, therefore we use ultrasound guidance to verify correct placement of the synthetic join lubricant. There is some communication between these adjacent midfoot articulations or joints and therefore there is additional benefit by injecting the second metatarsal–cuneiform joint to some of the adjacent communicating joints.  We typically use Supartz which is a highly purified form of hyaluronic acid.  I typically use the same protocol for other joints such as the ankle joint which is a series of injections at 1 to 2 week intervals usually 3 to 5 injections. 

If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online today. 
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Dr. Timothy Young
 a board certified foot surgeon discusses how to enhance results of hallux limitus surgery with a cheilectomy.
For early to moderate stage hallux limitus with degenerative joint disease and adaptive changes of the great toe joint, a common procedure is a cheilectomy. During this procedure, the bone spurs or osteophytes are removed and additional bone is removed from the dorsal or top of the first metatarsal head.
In addition, during the surgery the joint fluid is flushed out of the joint space. This is joint fluid that is produced by of the synovial lining of the joint. After the surgery is done additional joint fluid will replenish this loss of joint fluid.  We can augment this process. We commonly add synthetic joint lubricant to the joint early during the postoperative period. We currently use Supartz Hauluronic acid to enhance our results after surgery. This facilitates early range of motion and, also has a protective effect on the cartilage. In addition, ultrasound guidance is used to verify the correct position and placement of the Supartz directly into the joint. Early physical therapy can be beneficial also. 

If you have arthritis of your great toe joint or questions about potential surgery or procedures for this please request a consultation at our clinic. Give us a call today at 425-391-8666 or make an appointment online today. 


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Dr. Timothy Young
, a Board Certified Foot Surgeon, Discusses Supartz Injections for Ankle Arthritis

Synthetic joints lubricants such as Supartz are an effective treatment that we have been using at our clinic for over 10 years. Many of the patients who have arthritis believe that surgery is the only other option for them and are not aware of options such as Supartz. We typically use ultrasound guidance to make certain that we are directly within the joint itself.  A local anesthetic is also utilized ahead of time to help make our patients more comfortable during the Supartz procedure.

Studies with this treatment recommend a series of five Supartz injections. Our typical protocol would be to do five injections at 1–2-week intervals. Many of our patients have relief after the first injection and the relief continues to improve with each additional injection. Many of our patients are virtually pain-free after this and this relief can last up to a year or longer.  Supartz his one of the commercially available highly refined sympathetic joint lubricants with the primary ingredient being hyaluronic acid.  This type of treatment is a fraction of the cost of surgery and without the surgical risks.  Unlike cortisone there is no typical "injection flare“ after the injection.  Our patients can go back to normal physical activity the next day.
If you have ankle pain or have injuries and have residual ankle arthritis and pain please contact our office for a consultation. Give us a call at 425-391-8666 or make an appointment online today. 
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Dr. Timothy 
Young, a board-certified foot surgeon discusses treatment options for arthritis of the ankle.
Arthritis of the ankle can be a challenging problem to treat. This is a condition that can happen years after an injury with posttraumatic arthritis, degenerative joint disease and arthritic spurs or osteophytes. Some of the internal damage to the joint can involve damage to the cartilage. The end result is pain in the joint, especially with motion and with activity.
Treatment for arthritis can range from supplements to help decrease some of the inflammation and pain anti-inflammatory pain medication, braces to help limit motion, antiInflammatories, topical and oral, changing activities, or surgery.

However, there is another treatment option that is extremely effective.  Synthetic joint lubricants can offer relief quickly they can last for a year or longer.
Prior to this type of treatment, it was common to do cortisone injections. However, cortisone can further damage the joint overtime and. Cortisone injections are a short-term fix that can have long-term residual damage to the joint: weakening the existing cartilage.  Repeated injections can also weaken the bone.  Surgery can offer relief but takes significant time to heal.  There are ankle implants and there is fusion of the ankle.

If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today. 

Bunion


Bunion surgery
has been around for almost 200 years.  There have been many types of bunion surgeries performed during this time.  The vast majority involved cutting the bone and realigning the joint.  The recent years have allowed for advancement in correction techniques and better long-term outcomes.  Presently most surgeons either utilize a head technique, cutting the bone and realigning, or a base technique, which usually involves fusion or a Lapidus type procedure.

Lapiplasty has improved outcomes by creating a system that is reproducible and easier for surgeons to execute.  It involves a system of tools that the surgeon gets the proper correction for all patients.   The Lapiplasty is a new way of doing a bunion surgery that has been around for over 100 years.    The Lapidus bunionectomy is one of the most tried and true bunion correction surgeries and has great outcomes.  It is the primary work horse of bunion surgery and is probably the most common procedure I utilize.  If you have a painful bunion and would like to have it evaluated, make an appointment today and I will help you come up with a long term plan. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

Bunion xray


Bunion surgery
is probably the most common procedure I execute.  Most bunions can be fixed in about 2 hours and provide great long-term results.  The most important factor is to have a thorough workup and x-rays to evaluate the foot.  Once the foot and x-rays have been done then a plan for surgical or conservative care can be formulated. 

If surgical intervention is called for, our office has an onsite surgery center which can save the average patient thousands of dollars as compared to free standing ASC’s or the Hospital.  Our certified surgery center provides the best possible patient experience and has been functioning for over 15 years.  If you have a bunion and have been contemplating what to do, I can help.  I really enjoy helping people with bunions.  Please make an appointment and we can discuss your options. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

Bunion

Bunion surgery
is one of the most performed surgical procedures in the United States.  The bunion can be corrected with many different types of procedure from osteotomies (the cutting of bone) to arthrodesis (the fusion of bones).  Lapiplasty procedure is relatively new but utilizes a technique that has been around for years.  The procedure is based on a Lapidus bunion surgery. 

This procedure was named after a Dr Lapidus.  It involves fusion of a tarsometatarsal joint to stabilize the foot and fix the bunion.  The Lapiplasty allows for surgeons to have reproducible results utilizing special equipment and cutting jigs.  I find Lapiplasty to be a reliable tool for bunion correction.  Especially useful in large bunion cases and with people that have had long standing bunions.  If you have a large bunion and would like to speak with a Lapiplasty Surgeon please contact my office and we can see if you are a candidate. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

Bunion xray

The Lapiplasty technique has created an effective tool for bunion surgery.  The foot and ankle surgeon community has seen a reproducible tool that has helped revolutionize bunion surgery.  This procedure has helped bunion surgeons get the best possible correction with incredible long term outcomes.  The Lapiplasty combines a tried-and-true bunion surgery technique with modern jigs and fixation.  Bunion surgery is challenging and any tools that can help with getting better outcomes are looked upon favorably.  This is the case for the Lapiplasty system. 

As a Board-Certified Surgeon and Physician and somebody that has done 1000’s of bunion surgeries, this is a welcomed tool in my armamentarium.  I have found that Lapiplasty is a game changer.  I find my results are outstanding and long lasting.  I look forward to helping more patients with bunion recover faster and returning earlier to activities is a giant plus! If you suffer from bunion pain come see if you are a candidate for Lapiplasty. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

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Dr. Timothy Young
, A Board Certified Foot Surgeon, discusses postsurgical scar formation and supplements.  
There is always scar tissue formation after foot surgery.  The obvious scar formation is the skin incision.  But the scar extends all the way deep to the entire surgical area that was treated with surgery.  For example, with bunion surgery the capsule of the great toe joint has to be incised to access the joint and the bony prominence and also allow for any bone work or osteotomy.  After the deep bone work is complete the capsule is sutured back together and has to heal.  But the capsule may scar down tightly and limit post surgical range of motion.  

In addition after bone is resected bone often has excellent blood flow and there can be a blood clot or hematoma on the surface of the bone, deep within the wound.  This can be resorbed by the body and also can eventually convert to scar tissue and again cause ongoing swelling or stiffness to the surgical site.  Two supplements may be helpful for this.  One is nattokinase and the other is serrapeptase.  Both of these supplements should be taken 30 minutes before food for best absorption.  The nattokinase can be taken once a day and this serrapeptase can be taken twice a day.  Talk to your surgeon or naturopath to further discuss the role of these supplements with your particular situation.

If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today. 

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