The Schottenstein Center
Some of the Services offered by our practice:
An evaluation and care plan at the Schottenstein Center involves much more than just examining a patient’s foot or ankle. A complete examination will look at a patient’s lower limb’s bones, joints, connective tissue, circulation, nerve function, skin and nails, gait, and footwear. The patient’s full medical history will also be discussed and taken into account, in addition to his or her foot or ankle problem to help formulate the most accurate diagnosis. When a diagnosis is made, the patient’s, unique lifestyle, and goals for treatment will all play a part in creating a customized evidence-based treatment plan.
Using the latest high-tech digital X-ray equipment allows us to take X-rays with the best image quality. Digital X-rays are superior to traditional film X-rays because they provide larger, clearer, color-enhanced images that can result in a more accurate diagnosis while exposing the patient to much less radiation (up to 90% less) than with traditional X-rays.
While surgery is sometimes necessary, the good news is that most foot and ankle issues can be treated successfully with non-surgical care. At the Schottenstein Center, we always strive to employ conservative options first, whenever possible, to treat a patient’s problem, and design a unique treatment plan to fit the needs and lifestyle of each of our patients. Treating a patient conservatively can be as simple as recommending certain exercises, prescribing a particular medication, physical therapy, custom orthotics or bracing, padding, or trying different shoe gear. Dr. Schottenstein has also partnered with a custom bracing expert to provide patients who need custom bracing with the finest brace available that will help support them and allow for improved function.
When conservative treatments are not indicated, or when they are ineffective at improving the patient’s symptoms, foot and ankle surgeries sometimes become necessary to resolve various conditions or deformities caused by injury, genetics, or biological changes. Dr. Schottenstein will determine which surgery is right in each circumstance, and then take the time to discuss your options and address any questions and concerns, so you can make an informed decision. Dr. Schottenstein has undergone extensive surgical training in the surgical treatment of the foot and ankle and has also undergone fellowship training in advanced techniques in reconstructive foot, rearfoot, and ankle surgery. Whatever, the treatment indicated, Dr. Schottenstein will take the time to go through all of the options with you and create a customized treatment plan, so you can get back on your feet, pain-free, as soon as possible.
Minimally invasive surgeries refer to procedures that the surgeon can accomplish through very small incisions or even no incision. The surgeon can perform these procedures in such as way as to cause little to no trauma to the affected area and patient. These procedures can include utilizing tools such as endoscopes, laparoscopes, or lasers. Minimally invasive procedures often require less recovery time, involve less bleeding, minimal amounts of anesthesia, minimal scarring, and less pain.
During a biomechanical examination Dr. Schottenstein will examine how your lower limbs work, check for abnormalities and possible causes of pain in the foot, ankle, knee and back. After the biomechanical examination is performed, a dynamic Gait Analysis is usually conducted. Gait Analysis is an important part to understanding pathology because it allows us to examine the biomechanical conditions and dynamic forces that are affecting the foot and ankle while in motion.
Great toe arthritis is a common problem that leads to severe pain which limits everyday functional activities. The synthetic cartilage implant, Cartiva, is made of the same material as contact lenses and is designed to relieve joint motion pain. Dr. Schottenstein can help determine if this procedure is a good fit for your issue and lifestyle.
Custom orthotics are biomechanical medical devices that are custom made and designed for each patient to stabilize the foot and ankle into the most anatomically efficient position to correct foot imbalances and protect sensitive regions of the patient’s foot. Video gait analysis is also performed on all of our patients to help properly account for the biomechanical conditions that are affecting the foot while in motion during the gait cycle.
Proper footwear is an essential part of an overall treatment program for people with diabetes, even at the earliest stages of the disease. If there is any evidence of neuropathy, wearing the right footwear is crucial.
Diabetic orthotics work to accommodate, stabilize, and cushion the foot while also supporting any deformities present. Both pre-made and custom-made orthotics are commonly recommended for patients with diabetes. Total contact orthoses are created from a model of the patient’s foot and offer a high level of comfort and pressure relief.
An in-depth shoe is a basis for most diabetic footwear prescriptions. The in-depth shoe has an additional 1/4-inch to 1/2-inch of depth throughout the shoe. This extra volume accommodates inserts, orthotics, and deformities commonly associated with a diabetic foot, when present. In-depth shoes are designed to be light in weight, have shock-absorbing soles, and come in a wide range of shapes and sizes to accommodate virtually any foot
For those eligible, Medicare provides coverage for extra depth shoes or specially molded shoes, and inserts, for those with advanced cases of diabetes who have neuropathy and those who have undergone amputation.
With an imaging facility located on-site at our Hollywood office location, the friendly staff at The Schottenstein Center can help facilitate scheduling you for your MRI or CT scans quickly, sometimes even getting the patients in to get a test done the same day!
Platelet-Rich Plasma (PRP) therapy is a revolutionary procedure that uses platelets from the body’s own blood to promote the growth of new tissue and stimulate the natural healing and repair process in certain orthopedic and podiatric conditions. PRP works by delivering a concentrated dose of these platelets, and their healing factors, through a simple injection. The patient benefits by getting effective pain relief, faster healing, and it can sometimes eliminate the need for surgery.
Some of the conditions PRP therapy has been shown to be effective for include, but are not limited to, acute and chronic tendon and ligament injuries such as partial tears, plantar fasciitis, tendonitis, strains, and sprains.
Following the procedure, patients are placed in a CAM walker for approximately two weeks to promote stability in the ankle and foot and to restrict motion and weight-bearing activity.
The Schottenstein Center offers the latest in advanced stem cell procedures for foot and ankle conditions. Cell-based therapy and PRP injection treatments can help patients to alleviate pain with a non-surgical injection procedure and possibly avoid the need for surgery.
Stem cell therapy is routinely sought out in other countries as an option for non-surgical management of injuries and conditions. Within our bone marrow and fat, there are specialized cells called stem cells. These cells have yet to differentiate or develop into a particular kind of tissue cell. These stem cells have the potential to become bone, tendon, ligament, cartilage, muscle, or skin.
Stem cell treatments work by taking advantage of the body’s ability to repair itself. Stem Cells have anti-inflammatory properties, similar to cortisone and steroid shots. Cell-based therapy is used to treat conditions like joints injuries, muscular injuries, wounds, ligament injuries, and arthritis.
While cortisone and other drugs can provide pain relief, the effects are sometimes only temporary. Stem cells actually offer the additional benefit of being able to restore degenerated tissue while also providing pain relief.
Please contact our office to schedule a consultation to learn how you may benefit from stem cell therapies.
Ingrown nails are one of the most common nail impairment that we see at The Schottenstein Center. Nails usually grow out straight, but certain conditions including improperly trimmed nails, fungal infections, tight shoegear, heredity, and trauma can cause one or both corner of nails to grow into the soft tissue of the toe, often leading to irritation, redness, swelling, and even infection.
Dr. Schottenstein will remove the ingrown portion of the nail to get you out of pain fast! Patients also may be prescribed a topical or oral medication to treat the infection. If ingrown toenails are a chronic problem, Dr. Schottenstein can also perform a procedure to permanently prevent ingrown nails from growing back.
Total ankle arthroplasty (total ankle replacement) is a surgical procedure used to relieve pain and restore movement to damaged and arthritic ankle joints. Severe pain, stiffness, limited range of motion and an eventual loss of function of the ankle can limit both mobility and quality of life. During a total ankle replacement, the damaged ankle joint is surgically removed and replaced with an artificial replacement joint, which helps restore function and motion to the joint.
Ankle fusion is the other surgical option for severe ankle arthritis. There are pros and cons of both procedures, which should be discussed to select which procedure is right for each patient. After a total ankle replacement procedure, most patients experience significant relief from pain, and increased movement at the ankle joint. Physical therapy is an essential part of the recovery process after a total ankle replacement in helping to restore movement and mobility to the ankle and return the patient to an active lifestyle.
The legal department at The Schottenstein Center can assist you with scheduling independent medical evaluations (IME), depositions and live or phone conferences with our board-certified physicians. An IME consists of a complete review of records, patient history, and physical examination in order to address specific questions. Dr. Schottenstein can offer an objective and comprehensive independent medical evaluation. [ + ]IMEs can support a variety of needs, including:
- Diagnosis and treatment
- Causal relation clarification
- Medical status evaluation
- Prognosis analysis
- Maximum medical improvement
A thorough review of the medical and non-medical documentation will be provided in a narrative report and utilized to support factors including severity of diagnosis, physical impairments, functionality, restrictions and limitations, disability rating, treatment recommendations, and other requested issues.
A wound that persists for months or years needs specialized care. The Schottenstein center has a record of success with healing even the most difficult wounds. Dr. Schottenstein has vast experience in dealing with wounds due to all causes, on the legs and feet. Poor circulation, diabetes, pressure, immobility, and venous insufficiency often result in wounds that do not respond to ordinary treatment. Problem wounds can also complicate the treatment of other conditions such as heart, lung, and kidney disease. The Schottenstein Center has developed proven, successful treatment plans individualized to fit the needs of all patients.
Dr. Schottenstein also has access to an extensive experience using the latest wound care products such as skin grafts, skin substitutes, collagens, and specialized dressings promote healing of chronic wounds. After getting the wounds healed, she utilizes a number of different tools to help keep the wounds closed and prevent new wounds from occurring.
Disorders of the foot and ankle develop from a wide range of causes. When conservative treatments do not work, or are not indicated, reconstructive surgery may be used to achieve repair or treatment for the foot or ankle conditions caused by birth defects, diseases, and injuries. These procedures can help improve the medical, function, and quality of life of the patient.
Reconstructive surgery can often be performed on an outpatient basis with minimally invasive techniques, but other complex conditions may still require a traditional open procedure. Recovery time depends on the type of condition being treated, and may also be accompanied by immobilization with a cast or brace followed by physical therapy.
Arthroscopy is a minimally invasive procedure used to diagnose, treat, and relieve chronic pain from injuries and abnormalities within the joints. The arthroscopy procedure is less invasive than traditional surgery and allows the doctor to view and repair joints without making large incisions, shortening recovery time.
Some conditions that can be successfully treated using arthroscopy:
- Scar tissue
- Osteochondral lesions of talus
- Bone spurs
The arthroscopy procedure usually takes about 45 minutes to perform. Following arthroscopy, exercise and other strenuous activities should be avoided about six weeks.
An Endoscopic Plantar Fasciotomy (EPF) is another example of a minimally invasive procedure that is performed by Dr. Schottenstein. Plantar fasciitis can cause daily pain and take a patient away from his or her active lifestyle. Most of the time plantar fasciitis responds to conservative treatment, but when it continues to be a problem, an EPF can be a minimally invasive solution that offers relief and a fast recovery. The procedure is performed through two small incisions in the foot, each less than a centimeter long. A camera is inserted into the foot and the tight plantar fascia band is released. The incisions are sutured with 1-2 sutures and the procedure takes under an hour. Patients are placed in a CAM boot walker after the surgery and allowed to walk right away!
For your convenience, The Schottenstein Center, offers a variety of braces, splints, and shoes, and boots onsite in both our Miami and Hollywood offices. After your evaluation with the doctor, you will be properly fitted with the device that best protects you from additional injury. Braces and splints are often used following surgery or to control pain associated with conditions such as arthritis, tendonitis, and fractures. Braces and splints are used following surgery or to control pain associated with conditions such as arthritis, tendonitis, and fractures. We carry a wide variety of braces and splints, and we can also custom make one specifically for you. Braces and splints are used following surgery or to control pain associated with conditions such as arthritis, tendonitis, and fractures. We carry a wide variety of braces and splints, and we can also custom make one specifically for you.
Braces and splints are used following surgery or to control pain associated with conditions such as arthritis, tendonitis, and fractures. We carry a wide variety of braces and splints, and we can also custom make one specifically for you.Braces and splints are used following surgery or to control pain associated with conditions such as arthritis, tendonitis, and fractures. We carry a wide variety of braces and splints, and we can also custom make one specifically for you.