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Eschen continues to expand!

Eschen is pleased to announce its expansion to facilities in Hicksville and the Bronx.  Eschen has retained Dave Ballman CPO, Fred Winther CP, Jason Jordan CO, Sergio Cortez CO, and Michael Fram CP, practitioners experienced with these locations who will continue to provide the same level of customer service you are accustomed to as an Eschen patient. Please see the location tab for more detailed information regarding these new offices.

 

Study Proves Adolescent Scoliosis Bracing is Effective

A study published in the New England Journal of Medicine last week confirms what we in the orthotic community have long suspected, that bracing for Adolescent Idiopathic Scoliosis (AIS) is a successful method of treatment.    The primary analysis of the study showed patients who were braced had a 75% success rate, while those who weren’t braced had just a 42% success rate.  This was deemed significant enough to stop the study before completion, as ethically they could not continue with the randomized unbraced group.

Bracing for scoliosis began in the 16th century, utilizing metal bars and traction devices.  Since then, technological advances have made it possible to fabricate a brace out of a strong plastic that is thin enough to be worn under clothing.  Most physicians prescribe bracing for AIS patients that have curves of over 25 degrees, but under 50 degrees.  There several different styles of braces, and some that can be worn all day or only at night.

This study included patients from all over the US and Canada, from 25 different orthotic sites, and let the practitioner use the style of brace that was deemed appropriate for the patient.  Success with bracing is determined not by the amount the curve was lessened, but by slowing the curve from progressing.  This study characterized success by the patient reaching skeletal maturity before the curve advanced to 50 degrees.

A key factor in scoliosis bracing is not only putting the brace on, but the length of time the brace is worn.  Each brace was fabricated with a temperature sensor.  When the temperature read 82 degrees or higher, the patient was wearing the brace.  So the evaluators could not only tell if the brace was being worn, but for how many hours a day.  The data showed that a scoliosis brace must be worn AT LEAST 13 hours a day, as those patients had success rates over 90%.

AIS has long been difficult to treat, and the data has been suggestive, but not conclusive in respect to bracing.  This study not only states that scoliosis bracing is effective, but that we may be doing our children a disservice by not considering it an option.

http://www.nejm.org/doi/full/10.1056/NEJMoa1307337

Osteoarthritis Relief

Osteoarthritis(OA) of the knee is a painful and debilitating inflammatory condition that affects millions of Americans. The CDC estimates that 1 in 2 people will get symptomatic knee OA in their lifetime. Many of these people are healthy, middle-aged individuals who may not be ready to have a knee replacement. Others are simply not candidates for surgery. What are their treatment options?

First and foremost, a healthy and active lifestyle should be promoted. One pound of weight gained is equal to four pounds of extra pressure on the knee joint. While weight loss will not “cure” OA, it can relieve some of the symptoms and slow the progression of joint deterioration. Mild to moderate exercise keeps the joints mobile, helps decrease inflammation, and increases strength and flexibility.

In addition to diet and exercise, recent studies have shown that OA bracing can provide pain relief and a return to desired activity levels. OA braces, also known as unloaders, come in many different styles, but they all function to relieve the pressure from the affected aspect of the knee. It is important when selecting an OA brace that you work with your practitioner to find a brace that you are comfortable with and that fits your lifestyle. If you have any questions about OA bracing, please ask your physician if this is an option for you. The links below show a short informational slide show about osteoarthritis, and a brochure detailing Eschen’s OA bracing solutions.
http://www.webmd.com/osteoarthritis/ss/slideshow-osteoarthritis-overview
OA rack card (2)
OA xray

Prosthetic Arm Controlled by Neuromuscular Implants

Doctor Rickard Branemark MD, MSC, PHD and his team at Sahlgrenska University Hospital in Sweden have perfomed an operation on a transhumeral amputee that is nothing short of groundbreaking. According to the publication O and P Edge, they have implanted electrodes into the patient’s muscle and nerves that will allow him to control an osseointegrated prosthetic arm. By implanting the electrodes, the arm will receive stronger signals and therefore make a larger amount of movements possible. This technology can also cut down on the mental fatigue that occurs when an amputee begins to use and train muscles to signal the prosthesis. Doctor Branemark sees other potential advantages to using these electrodes, “The next step will be to test electrical stimulation of nerves to see if the patient can sense environmental stimuli.”

There are, of course, several issues that a surgery like this can bring up. For example, the surgery was performed, but it still remains to be seen how the patient is able to tolerate the electrodes and the arm, and to what functional level he will be able to return to. There is also the risk of infection with osseointegration. According to a study by Branemark et al. Osseointegrated Titanium Implants for Limb Prostheses Attachments: Infectious Complications, osseointegrated limbs have up to an 18% infection rate. It is for this reason that the FDA here in the United States is reluctant to approve this technology.

Regardless of where the procedure is and can be performed, this is a big breakthrough and has promising implications for the future of prosthetics. Dr. Branemark probably puts it best when he says ““The ultimate goal is to make a more natural way to replace a lost limb, to improve the quality of life for people with amputations.”

Link to original article here http://www.oandp.com/articles/NEWS_2013-02-22_01.asp

Link to infection study here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939339/