Metatarsalgia Secrets

Futura™ LMP Lesser Metatarsal Phalangeal Implant

Concept: First prosthesis designed specifically for lesser metatarsophalangeal joint arthroplasty.

Made from UltraSIL™ silicone, the LMP prosthesis is monoblock and comprises two specially-designed stems for optimum fit in the proximal phalanx and lesser metatarsal intramedullary canals. Indications The LMP implant is indicated for treating lesser metatarsophalangeal joints in cases of: Avascular necrosis and for surgery to reduce arthritic joint pain.

This sort of implant technology may serve as a cornerstone for severe pain which may not be readily diagnosed initially in the case of this patient. This has been present for years and seemingly no treatment up to this point has been administered. There is little to offer outside of surgery when it gets this advanced. 

Come in to see your specialist, because the longer you wait, the less is able to be done to reduce your pain.

Dr Timm

Board Certified 

Diplomate American Board of Podiatric Surgery

What you need to know about Vitamin D

JT Smith, et al. at the Brigham hospital conducted a study which correlated vitamin D deficiencies
 with certain types of foot and ankle fractures. 

In our practice, we may order Vit D 25 studies on any patient presenting with signs of pedal osteopenea, with or without a history of foot or ankle fractures or sprains, who demonstrate a very light bone mineralization pattern on a plain radiograph. This is not age dependent, and even though most female patients are more likely to present in this manner post menopausal age, we have found this in both male and female patients in their early thirties.

In almost all cases, if we see it in the foot, the lab tests come back positive for a vitamin D deficiency globally in the body and we may initiate Vitamin D supplementation along with primary care and nutritional consultation.


If the levels are below 20, we prescribe 50,000 units of Vit D to be taken one per week along with a daily
OTC supplement of three to five thousand units of vitamin D 3 to be taken daily. Because the research in how to raise the levels and whether doing such will prevent foot injuries is scant, it is likely that different
doctors will have different protocols for raising vitamin D levels in order to prevent pedal osseous pathology.

Kobe Bryant is still recovering...

To those of us who routinely see and treat Achilles tendon tears/ruptures/tendonosis, we are not surprised. In fact, most patients will take up to 12 months before they are able to fully utilize their leg in the similar manner that was done prior to the injury. I have found that 8-9 months is possible for a recovery after open Achilles repair for healthy patients, but these are not people who are dunking basketballs and chasing down 24 year old players as a shooting guard in the NBA. Kobe is an amazing athletic specimen, and it should not be too long before someone with drive and determination can beat any injury with the proper training and realistic expectations, but patience is key. Mere mortals require the time to get their strength, endurance, and collagen reorganization of the tendon fibers to fully become tensile again.

Notice that in his Twitter picture, he has a syringe with a needle penetrating into his achilles operative site. This is a PRP injection. We have the technology to perform this without an incision right in office for any tendonopathy or other foot and ankle concern. If you are a candidate (based on diagnosis) we can plan for 30 minutes without sedation a quick and proper recovery.

Dr Timm