New Model for Foot and Ankle Research and Innovation

Massachusetts General Hospital’s Christopher W. DiGiovanni, MD, chief of Foot and Ankle Service, and Daniel Guss, MD, MBA, orthopaedic surgeon in the Foot and Ankle Center, discuss how the researchers in the Mass General Foot and Ankle Research and Innovation Lab collaborate to develop better diagnosis options, technologies and surgical techniques so that care is accessible and effective for patients.

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Transcript

Dr. DiGiovanni: Here at Mass General, we have recently created a new model for research which has few predicates across the United States, and it is called the MGH Foot & Ankle Research and Innovation Lab.

Dr. Guss: It's an actual center focused not upon the physician's need, but around the patient's need, its entire center, whether be it the people, the technology and the resources to treat foot and ankle conditions.

Dr. DiGiovanni: We are in the operating rooms, in the clinics, on the fields, seeing the problems and injuries that these patients have, and then trying to figure out the optimal way to take care of them. What happens is that generates a lot of questions. We will take those questions back to the lab and try to innovate better materials, better implants, better surgical techniques, all of these things as a means of then bringing that back to patient care, to the point of care.

Dr. Guss: Technology is constantly pushing forward, be it for the implants that we use for total ankle replacements, the way we fix things, that's constantly getting pushed forward, and then we also have, increasingly are using biologics, things like bone growth stimulators to try to maximize our outcomes. Arthroscopy is generally done in the operating room, but now we're using ultrasound in the clinics in order to have a live dynamic view of certain foot and ankle conditions in a way that wasn't available before. MRI is very good at showing injury, but it's not a living dynamic process. With ultrasound, we can apply stress to the ankle and actually look at the relationship between the bones, ligaments, tendons and what they're doing right at the point of care.

Dr. DiGiovanni: We're focusing on ligament injuries in the midfoot called a lisfranc injury. We are focusing on better ways to take care of fifth metatarsal fractures, which are very common in high profile elite or very active athletes and other individuals. We are focusing on better ways to look at ankle replacement and how to create better ankle replacements for patients who have badly arthritic joints. We've probably got 40+ projects right now that we are working on with people from seven or eight different countries around the world who at any point in time are with us in our lab and are sort of the engine that help drive this research.

Dr. Guss: We treat anybody from pediatrics to people that are in their 90s, and even 100, and so it's a huge range of people. We also are trying to make these treatments more accessible to foot and ankle patients. The Massachusetts General Hospital opened up a Foot & Ankle Store that was curated by medical professionals ranging from orthopedic surgeons to podiatrists to physical therapists to try and bring everything that we need to the point of care, and so I think what we're doing, especially uniquely, is assembling the right people who are devoting an enormous amount of effort and thought to improving the care of foot and ankle patients, and then giving them the resources to succeed.

Learn about the Foot and Ankle Service

Refer a patient to the Foot and Ankle Service