Monday, 22 July 2013

Interview with Ron McColloch, Podiatrist at London Podiatry Center

Today I have an interview with Ron McCulloch. See below for the interview and details. I actually got in touch with Ron because his centre treats Ledderhose but it also uses Cryotherapy. He has not yet used cryo to treat plantar fibroma's but has not ruled out used it for this purpose in the future.
 Bio: 
Ron McCulloch is the principal Podiatric Surgeon and Director of the London Podiatry Centre. During his many years as a specialist Podiatric Surgeon, he has performed thousands of successful foot operations.
Ron McCulloch is Consultant Podiatric Surgeon at London's Homerton University Hospital.He lectures extensively both on the national and international circuit and helped to develop podiatry in the Middle East.
Ron McCulloch built a state of the art gait laboratory at The London Podiatry Centre. This is one of the most advanced dedicated podiatric gait facilities in the world. He is a published author on surgical techniques and is one of only two practitioners in Great Britain to offer invasive cryosurgery of the foot. 
This information was taken, with Permission from http://www.londonpodiatry.com/podiatry/staff/
1)    How long having you been treating Dupuytren's and Ledderhose disease?  
About 20 years
2)    Roughly how many Dupuytren's patients have you treated and how many Ledderhose patients have you treated?
 Plantar fibroma formation varies from discreet nodules to multiple lesions. (Of course you know this).  I have probably treated several hundred of these over my career. They are not uncommon.  I cannot recall exactly how many I have operated on probably around 20 or 30
 3)    What treatments have you used for these conditions? Would you recommend the treatment and roughly how successful is the treatment for each condition?
 Conservative care/redistributive orthoses. Injection therapy, mainly steroid. Surgery to excise the lesions. As you know I'm now looking at providing cryosurgery as cases now come along.

 4)    What would your recommendations be to Dupuytren's and Ledderhose patients and do you have any advice you would like to give?

 Always start with conservative care. If this fails injection therapy which involves breaking the fibroma down with a needle and then infiltrating the steroid. After this I would be inclined to try cryosurgery and full wide excision if this fails.

 5)    What do you think of other treatments such as steroid injections, Xiapex, Radiotherapy and cryosurgery (which I see you do for other conditions)? 

 I only have experience with injections and excision.  The key thing with excision is to do a large marginal one to minimise the chance of recurrence.

 6)    What success have you had with cryosurgery for other conditions? 

 I have done almost 100 operations with cryosurgery but these have mainly been for the management of neuroma formation. As of now I have not had to treat   fibroma using cryosurgery as this is a fairly new treatment in our facility. However when the right case comes along I'm sure we will be using this as part of our armoury to treat plantar fibroma formation.