Welcome to the Website of
Dr. Michael Zapf, DPM, MPH, FACFAS
Call: (818) 707-3668
Thank you for visiting my website. I have been placing information and articles on this site for many years and have received millions of hits during that time (and not that many of them were mine). I have designed it for people who like to read about their foot and ankle problems. Since I started the web site, I have added two associates to my practice, Dr. Darren Payne and Dr. Stephen Benson. Since my site is filled with just my thoughts and opinions they are not, necessarily, shared by my colleagues. To see our less controversial (and less windy) practice web site, I offer you: www.ConejoFeet.com, the practice site for The Agoura Los Robles Podiatry Centers (ALRPC). The ALRPC practice site has a lot of material about our office, many of our policies and the registration forms to be filled out before your visit. I suggest all prospective patients visit www.ConejoFeet.com.
I made the web site to give my patients the extra depth information that I donít always have time to cover in the office visit. Visitors who are not my patients are welcome to browse the information found here. I am from a generation that likes to read in depth about all sorts of things, including our ailments. This site is dedicated to all those who want more information that what can be contained in a series of bullet points. If you like this philosophy then let me know when you see me or if you ask a question.
Remember, this site is in no way intended to tell you how your own ailment or problem should be treated, only the approach I use when confronted with certain situations. Your problem may well be different from what you think it is and should always be evaluated by the appropriate professional, whether podiatrist, orthopedist or other authority. Please understand that I, nor anyone else, can offer you a proper diagnosis or treatment plan without seeing and feeling the problem at hand (foot?). Happy reading.
Sincerely, Michael Zapf, DPM, MPH, FACFAS, FACFAOM
P.S. All the information in this web site is © by me and it is mine alone. No picture and none of the articles can be used by anyone without permission from me, personally.
P.P.S. Comments about this web site or questions about your feet can be directed to me at zfootdoc (at) doctor (dot) com.
P.P.P.S. I was going to offer a nice prize to the person who could send me a screen shot of being the 3 Millionth person to visit this web site. I am sorry I missed that opportunity. But wait until you see what I offer the 4 Millionth visitor.
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TODAYS HEALTH December 1995
By: Michael Zapf, DPM, MPH, FACFO
The arrival of the new year makes me think of the countless times people have asked me for new feet. While replaceable feet are a long way off, replacing parts of it are here now. Perhaps the most exciting prospect is replacing lost or damaged cartilage. This technology is here now and is being performed on an experimental basis on knees at several centers across the country. Healthy cartilage lines our joints and loss of the cartilage is a major source of painful joint arthritis. In this new surgery healthy cartilage is harvested from a patient and grown in a laboratory. At a later operation the new cartilage cells are placed in an area that has lost its cartilage and allowed to grow. After a few weeks the heretofore damaged joint is good as new. Currently this procedure adds $40,000 to the cost of a knee surgery, but widespread use of this technology should bring down the cost. There is no reason why this procedure cannot be used on other joints, including my favorite ones in the foot.
So what are the current options for foot joints. Well, like with everything medical, prevention is the best policy. While trauma can damage a joint instantly, most of the foot arthritis I see is an accumulation of years of abnormal use of the joint. Some of this misuse can be traced to diseases like rheumatoid arthritis (RA). With RA the body is slowly damaging the delicate joints of the foot and hands. Medical treatment of RA can slow down, if not eliminate, the deformity. More common, and more unfortunate because they could have been corrected, are those joints that are mis-aligned in some way and simply wear out. An untreated bunion condition can cause the big toe joint to wear out. Lack of motion at the big toe joint is notorious for causing joint damage. A foot that is either too flat or, less commonly, too high-arched can develop arthritis of the mid foot. Repeated ankle sprains can cause a weakness of that joint that may develop into arthritis.
Arthritis can be treated medically with a whole host of medications: from lineaments to rub on the foot to oral or injected medications. One of the newer, and safer, agents is a pepper cream. Rubbing the cream several times a day over a painful joint can often lessen the pain. This cream is available without a prescription.
Arthritic joints hurt when the joint is moved so one method of treatment is to not move the joint. Supportive shoes, braces, taping and casts are external ways of limiting joint motion. This can be done surgically by removing the remaining cartilage between two joints and fusing them together. No motion means no pain. No motion also means that the neighboring joints must move more which can cause them to suffer further damage in a viscous circle. For arthritis joints in the middle and rear of the foot fusions are indicated when non-surgical treatments fail.
For the joints around the toes, including the big toe, reasonable good replacement joints exist. These joint replacements are getting more sophisticated with each passing year. While no artificial joint is as good as an undamaged joint, they can provide patients with 15 or more years of pain free motion.
Arthritic damage to the big toe joint is a special case and quite common. The world of foot surgeons is divided into two camps for this joint: the fusers and the users. For the most part podiatric surgeons are users and favor artificial joint replacements for this joint.
Replacement joints for the ankle have been tried but are almost universally unsuccessful.
Whats better than a new foot? Obviously one that does not need replacement. If you find you have foot joints that hurt, by all means do something about it early. After all, how many new sets of feet do you get? Happy New Year!
Dr. Michael Zapf is a board certified podiatrist in practice in Agoura Hills and Thousand Oaks. For more information, please call his office at (818) 707-3668 or (805) 497-6979.
Send mail to (zfootdoc at doctor
dot com) with questions or comments about this web site.