New Evidence on the Role of Hyperpronation in Peripheral Neuropathy Opens Eyes at Conference

Nov. 9, 2012 - PRLog -- Macomb, MI – Michael E. Graham, DPM, FACFAS, FAENS, founder of the Graham International Implant Institute (GIII), lectured at the annual Association of Extremity Nerve Surgeons (AENS) annual symposium in Scottsdale, Arizona. His lecture, on “The Role of Hindfoot Alignment in the Development of Peripheral Neuropathy,” was eye-opening to many of the attendees. The lecture was largely based on Graham’s published research in the Journal of Foot and Ankle Surgery, the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle.

AENS was founded as a society to promote the collaborative study and development of medical research regarding the treatment of extremity nerve disease. Membership is inclusive of MD, DO, DPM, PHD and medical student individuals interested in furthering the dissemination of current knowledge and development of basic medical research in peripheral nerve disease. Learn more about the mission of AENS at http://www.aens.us/index.php/.

There are many theories on the causes of peripheral neuropathy, though it is most commonly linked to diabetes as it commonly presents in diabetic patients. Treatment is usually focused on pain relief through the use of various medications, which have many side effects and do not control the progression of the disease process. Graham’s research supports and further strengthens previous studies that hindfoot misalignment, or hyperpronation, is a major contributing factor in excessive compression and elongation/strain on the tibial posterior nerve. This nerve supplies sensation to the bottom of the foot. In addition to this important and often over-looked finding, he presented the results of a multi-centered, randomized survey of patients who presented for consultation to foot and ankle surgeons with a complaint of pain and numbness in their toes and/or the bottom of their foot. Again, many people assume that this condition is limited to diabetic patients. His results revealed that less than one-fourth of the patients presenting with this condition were clinically diabetic, yet over 80% of them exhibited hindfoot instability. The age of onset was also analyzed which showed over 81% of the patients were 40 years old or older. Taking the average age of onset of symptoms combined with predominance of diagnosis of excessive hindfoot instability, these findings support the conclusion that excessive forces on the nerve caused by the recurrent talotarsal dislocation (hindfoot instability) over time leads to the development of neuropathy. By the time the average person reaches 40 years of age they have taken over 80,000,000 steps. That is 80,000,000 times the tibialis posterior nerve is over-stretched and compressed.

The lecture concluded by drawing attention to a medical breakthrough treatment for this condition – extra-osseous talotarsal stabilization. This involves the insertion of a titanium stent (HyProCure^®, GraMedica, Macomb, Michigan) in to a naturally occurring space in between the ankle and heel bones. Graham’s research showed that the insertion of this stent results in the realignment of the hindfoot. This decreases/normalizes the pressures within the nerve tunnels and also decreases the elongation and strain of the tibialis posterior nerve.

The evidence presented in these studies contribute to a paradigm shift in the treatment of peripheral neuropathy. “We cannot just assume that these patients are suffering from diabetic neuropathy, case closed. We must address and eliminate any source of nerve compression and strain and not just limit our treatment to medications,” said Graham.

About the Graham International Implant Institute^®:
GIII, the training partner of GraMedica, is committed to research, training, certification and support on implantology for foot physicians worldwide. In addition, they continue to look for and represent innovative, revolutionary products that help solve foot disorders at their root and don't just ameliorate the symptoms.

About GraMedica^®:
GraMedica is a global orthopedic medical device company and leader in foot care solutions. Recognized for its innovation, the company is producer of breakthrough products like HyProCure^®  and osteo-WEDGE_TM.

Contact:
Susan Doherty, Director, Education & Physician Resources
+1-586-677-9600
sdoherty@grahamiii.com