Re: To Dorothy Cryosurgery Lots of doctors seem to be offering it.
View full discussion posted to categoryPosted by Ralph on 12/18/05 21:38
Dorothy,
I certainly didn't mean to be sarcastic at all. I just thought it was interesting that I was able to find sooooo many Podiatry websites offering this new treatment. To go from 7 doctors when Dr. Wishnie introduced himself and Cryosurgery to us to so many in such a short period of time means to me that Manuf. Reps talked to many doctors and obviously sold them a machine or perhaps they made the contact at a medical convention. Either way there are a lot more doctors providing the treatment now. Maybe several doctors share machines like they do with ESWT too.
What really surprise me was a letter by a doctor in Podiatry Management saying that he'd been using Cryosurgery to treat neuromas since 2003. Since it was just brought to our attention this year I thought it was a brand new podiatric treatment for Neuromas and P.F., but I guess it old.
Some of the letters published in Podiatry Management pointed out that there are no long term or double blind studies published for Podiatric Cryosurgery for either neuromas or P.F.. I got the feeling that many DPM's would like to move toward evidence based medicine and are attempting to do so when they introduce these new treatments by producing their own published studies.
Cryosurgery used in other medical fields has been documented in accepted medical journals and appears to work well. My own personal feeling based on what I'm reading is that cryosurgery treatment for neuromas will show real positive results, but I don't feel the same way yet when it comes to treating P.F. so I guess that I'm HALF skeptical at this point in time.
In the right hands and performed for the right reason Cryosurgery looks very promising.
Here are the letters that I was refering to. They were published this year. You should visit Podiatry Management when you have time. Lots to read. The first two letters were part of a discussion about providing evidence based studies and could it be done for Cryosurgery.
03/25/2005 David E. Gurvis, DPM, David Zuckerman, DPM
Double-blinded Studies and Cryosurgery and ESW Therapy
RE: Double-blinded Studies and Cryosurgery and
ESW Therapy
From: David E. Gurvis, DPM, David Zuckerman ,DPM
They can, and recently have, blinded surgical
studies. It took guts on
the part of the surgeons and the patient, and
hospital administrators
(and probably the medical ethics committee). In
the study, they proved
(with sham surgery) that arthroscopic knee
chrondroplasty and sham
arthroscopic chrondroplasty had statistically
identical results as
measured by pain and functioning.
The study was done with all the required paper
work. Patients knew
they would have one or the other. The surgeon,
upon entering the OR, was passed a sealed
envelope, indicating real or sham surgery was to
be
performed. In the sham surgery, the standard
incisions were made, and sutured, without the
insertion of the arthroscope. Post-op care was
the same in all cases.
Possibly, can this ever be done with the
cryosurgery? It has been done
with the shock wave studies.
David E. Gurvis, DPM
Avon, IN
I agree with Dr. Weil that we need to move to
what is called evidence-
based medicine. It is here and our profession
must becoming part of this new and important
method for treatment efficiency evaluation.
Double blind, randomized , multi-center studies
are the gold standard that we should aim for. It
is possible to use this standard with cry
therapy. There was a study with arthroscopy knee
surgery when they did the actual incision. With
cryotherapy all you would need to do is place a
fake band aid over the fake incision and that
could be sham.
My point is that we need to stop looking for
excuses for this type of testing and think of
ways to actually do the testing. Is this
difficult? Yes. Can it do done. Absolutely. We
will look
back at this someday and think how could I ever
do a procedure without
some level of study. Cryotherapy and ESWT are
two treatments that can be done very easily.
Let’s not fight it
David Zuckerman, DPM
Woodbury, NJ
07/23/2005 Brian Richman, DPM
Cryoablation (G. Stephen Gill, DPM, MBA)
I have been performing cryosurgery procedures
since Sept 2003 with great results. It's about
80 % successful for neuromas, recurrent
neuromas, excessive scar tissue, plantar
fasciitis, Achilles bursitis, hypertrophic
scars, nerve entrapment, and fibromas. The
company is Cryotech 1-800-616-2796 PO Box 1868
Villa Rica Georgia 30180. They have two types of
machines the Cryostar and the Cryopac. If you
have any questions please feel free to call me
at 1-801-825-4709 or e-mail me.
Brian Richman, DPM
Layton, UT
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