What You Want to Know About Ankle Arthritis

According to the Mayo Clinic:
The two main types of arthritis — osteoarthritis and rheumatoid arthritis — damage joints in different ways.
Osteoarthritis
The most common type of arthritis, osteoarthritis involves wear-and-tear damage to your joint's cartilage — the hard, slick coating on the ends of bones. Enough damage can result in bone grinding directly on bone, which causes pain and restricted movement. This wear and tear can occur over many years, or it can be hastened by a joint injury or infection.
Rheumatoid arthritis
In rheumatoid arthritis, the body's immune system attacks the lining of the joint capsule, a tough membrane that encloses all the joint parts. This lining, known as the synovial membrane, becomes inflamed and swollen. The disease process can eventually destroy cartilage and bone within the joint.

I will concentrate on the osteoarthritis particularly in the ankle.  Most common complaint from a patient coming into the office:   pain , stiffness in the morning and relieves slightly after walking as well as swelling in the ankle.    Most will have history of ankle sprains or even a severe ankle fracture in the past. 

Did you know that even "mild" ankle fractures or sprains can lead to arthritis?  Ankle injuries can lead to OCD or osteochondral defects in the talus bone.    Translated: Pothole in the talus, the bone that connects to the ankle joint.  Will leave this for another blog to discuss treatment. 

Ankle arthritis or synovitis is inflammation of the ankle cartilage, joint inflammation from a variety of causes.    

Treatments: 

• NSAIDS: Motrin, Aleve, etc
• Steroid injections
• Platelet Rich Plasma injections
• Amniotic stem cell injections
• Ankle arthroscopy (scope of the ankle to roto rooter out the ankle joint)
• Ankle arthrodiastasis (stretch out the ankle joint after an ankle scope to provide room for new cartilage growth and recovery)
• Denovo  Juvenile cartilage grafts
• End stage ankle fusion or ankle implants

FFLC surgeons and physicians are well versed in treatment of this condition. 

Top technology and experience for this condition. 

Call 230 430 3668 for appt

Check out our various youtube videos discussing this disease. 

Lump on the top of the foot aka Ganglion Cyst of foot

Often, patients come into my office with a complaint of having a lump on the top of the foot. Sometimes they are referred here promptly from their primary care physician with concerned about this lump for possibility of cancer. The reality is that most of these lesions on the top of the foot happens to be a benign ganglion cyst.   

What is a ganglion cyst?

A ganglion cyst is a fluid filled sac usually with synovial synovial fluid. The synovial fluid has a very high viscosity which is the same fluid as a joint or a tendon which are two of the most common sites of origin of this to cyst. However, there are situations , and conditions that mimic a ganglion cyst that can be cancerous they are synovial sarcoma, giant cell, tumors or even bone tumors,  an MRI scan with contrast can help to differentiate the lesion.    Your podiatric surgeon will assess your individual situation. Those that require excision are:  rapidly increasing in size,  discoloration or  limits your ability to walk. 

Family Foot & Leg Center, we keep you walking and treat these bumps with ease. 

239 430 3668  option #2. 

Additional information from the American College of Foot and Ankle Surgeon about ganglion cyst below.

Ganglion Cyst

What Is a Ganglion Cyst?A ganglion cyst is a sac filled with a jellylike fluid that originates from a tendon sheath or joint capsule. The word “ganglion” means “knot” and is used to describe the knot-like mass or lump that forms below the surface of the skin.

Ganglion cysts are among the most common benign soft-tissue masses. Although they most often occur on the wrist, they also frequently develop on the foot – usually on the top, but elsewhere as well. Ganglion cysts vary in size, may get smaller and larger, and may even disappear completely, only to return later.

CausesAlthough the exact cause of ganglion cysts is unknown, they may arise from trauma – whether a single event or repetitive micro-trauma.

SymptomsA ganglion cyst is associated with one or more of the following symptoms:

• A noticeable lump – often this is the only symptom experienced
• Tingling or burning, if the cyst is touching a nerve
• Dull pain or ache – which may indicate the cyst is pressing against a tendon or joint
• Difficulty wearing shoes due to irritation between the lump and the shoe

DiagnosisTo diagnose a ganglion cyst, the foot and ankle surgeon will perform a thorough examination of the foot. The lump will be visually apparent and, when pressed in a certain way, it should move freely underneath the skin. Sometimes the surgeon will shine a light through the cyst or remove a small amount of fluid from the cyst for evaluation. Your doctor may take an x-ray, and in some cases additional imaging studies may be ordered.

Non-Surgical TreatmentThere are various options for treating a ganglion cyst on the foot:

• Monitoring, but no treatment. If the cyst causes no pain and does not interfere with walking, the surgeon may decide it is best to carefully watch the cyst over a period of time.
• Shoe modifications. Wearing shoes that do not rub the cyst or cause irritation may be advised. In addition, placing a pad inside the shoe may help reduce pressure against the cyst.
• Aspiration and injection. This technique involves draining the fluid and then injecting a steroid medication into the mass. More than one session may be needed. Although this approach is successful in some cases, in many others the cyst returns.

When is Surgery Needed?When other treatment options fail or are not appropriate, the cyst may need to be surgically removed. While the recurrence rate associated with surgery is much lower than that experienced with aspiration and injection therapy, there are nevertheless cases in which the ganglion cyst returns.


FFLC treats these and other foot / ankle ailments with ease. Call: 239 430 3668 option 2. 

Passing on your foot problems to your kids

Did you know that if you have ingrown nails, there is a 50% chance that your child will get ingrown nails?

If you have flat feet that caused terrible hip and back pain, your child may be doomed to such without proper monitoring and preventative care, a simple orthotic can help your child develop properly.

Continuing education a way of Life

Medicine and surgery changes very fast nowadays with innovative products and techniques.    Glad that the minimally invasive bunionectomy via the Lam modification is gaining traction as other doctors and more FFLC patients see the benefits.  
Patients are able to walk the day of surgery in a boot, even had a plastic surgeon return back to work 3 days after surgery!  This surgeon definitely appreciated the 6 mm bunionectomy.

www.ScarlessBunion.com    to see more photos and actual patient pictures.

Being award Amongst Top Podiatrists in America

Grateful to be recognized for my hard work and dedication to the foot and ankle surgery world.   That path was not always easy.   As a college student I was accepted to start podiatric medical school right after my toughest year as a junior.  As with all college students the senior year was to be a year to unwind, look for jobs, find ourselves and our future path.     On the fast track to the Doctor of Podiatric Medicine degree at the Temple University School of Podiatric Medicine, managed to still engage in NCAA Tae Kwon Do competition circuit and get graduation honors.     The dean of the school, Dr. Mattacci took me under his wing for my internship year after graduation from Podiatric Medicine, of which I am very grateful for.   The opportunity at Mt Sinai Medical Center in Miami Beach and Jackson Trauma Center in Miami was a great experience to learn all phases of podiatry from foot care to trauma and restorative / reconstructive surgery.    

Running an office, mentoring young doctors and student doctors has always been my way of giving back to the profession.     Treating patients and getting them better is my passion.  

Whether I'm at a conference learning or teaching new techniques, to being a consultant with various orthopedic companies and groups, the field of Podiatric Medicine / Surgery, excites my sense of community service and curiosity.

Thank you for the honor. 

Dr. Kevin Lam 

Snow Bird Season in #SWFL starts October

It is that time again where our northern friends return to enjoy our beautiful weather.   A few tips, when you are driving down, please make several stops and walk around to prevent deep venous thrombosis or clotting of the veins that can be deadly if progresses to the lungs.
Symptoms are redness, swelling, warmth of usually one let.  Present to the nearest emergency room immediately to get checked.  Any medical treatments and surgeries done up north, please bring a copy with you to your doctors here in SWFL.
Make sure that if you have had any address , insurance company changes, you let your doctor's offices here know about such.

Welcome back, enjoy our weather and hospitality.  If any of our patients requires a referral to a generalist or another specialist, please feel free to contact your FFLC doctor as we have a wide network  and have the inside information for your safety.

We have 3 offices to service your needs:
661 Goodlette Road, Suite 103
Naples, FL  34102

12250 Tamiami Trail East, Suite 101
Napes, FL 34113

1661 Medical BLVD, Suite 302
Naples, FL 34110

Central Scheduling:
Call: 239 430 3668
Fax: 239 692 9436

Jon Bon Jovi has heel pain relieved with endoscopic release

For the past three decades, Jon Bon Jovi has been performing concerts all over the world in front of millions of loyal fans. What those fans did not realize was that he was pushing through intense foot pain for many of those concerts. “The pain was so severe during my 2013 Because We Can Tour that I would want to jump through the ceiling whenever it was touched,” Jon says. “I got to the point where I was given injection therapy, orthotics, shockwave therapy, and platelet rich plasma (PRP) therapy, but they did not alleviate the chronic condition.” After the tour concluded, Jon revisited John Connors, DPM, a sports podiatrist at Riverview Medical Center.


Jon Bon Jovi and Dr. John Connors


At Riverview, under the care of Dr. Connors, Jon underwent endoscopic plantar fasciotomy (EPF), which is a minimally invasive and minimally traumatic surgical treatment for chronic plantar fasciitis. Six weeks is the typical recovery time for this surgery. “Exactly six weeks later, Jon was again walking and jogging on the treadmill,” Dr. Connors added. “He is now 100 percent for the first time in years.”

Source: Robert Cavanaugh, Meridian Health Views [September/October 2014]

From Dr. Kevin Lam:
EPF is a procedure using small stab incisions and a 4mm camera used to visualize the plantar fascia then a blade is inserted from the opposite side to cut the fascia to relieve the pain. FFLC has this and newer technology for those nagging heel pains.