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Thursday, November 2, 2017

Fat Pad Atrophy: Email discussion

This patient has fat pad atrophy post cortisone shot one heel and sesamoid area other foot. Here is a discussion we recently had regarding a procedure to move the fat pad placement and inject stem cells to encourage fat regrowth. The doctors are up in Pittsburg, Pennsylvania. I have reviewed the MRI for her noting tremendous scarring of the fat pad at the heel called panniculitis. 

Hi Dr Blake,

I wanted to get your opinion on this procedure. I have lost fat on the lateral side of my left heel as well as under my big toe (same foot) due to a cortisone injection for plantar fasciitis and sesamoiditis. Unfortunately, I haven't found any shoes that help or inserts, taping, etc. I've been doing a lot of research and found 2 doctors performing the Foot Fat Grafting. They're married, the wife is a podiatrist and the husband is a plastic surgeon. It seems like they've had good results for far in their pilot and research study.

What are your thoughts, do you think it's worth trying? I'm only 28 years old and the pain is unbearable. I just want my freedom back.

Thank you!

Dr Blake's comment:
      I reviewed and found the articles interesting and hopeful. They would, of course, recommend it if you went there. You would need a doc near you to followup, and hopefully, someone independent to think your pain is from the fat pad atrophy also. But, it sure makes sense. Rich

Thanks, Dr Blake. I've had one doctor say it'd atrophy but then others haven't. It's hard because I hear so many opinions, a lot of "plantar fasciitis" but I have the scarring in my heel fat pad that is shown on the MRI. They will do ultrasound prior to the procedure to confirm the thickness 

Dr Blake's comment: 
     I read their reviews. Also, see if you can talk to one of their patients. 

I spoke to one of the patients yesterday and it sounded promising, she only had it done 3 months this ago so hard to say if the fat stays and if the stem cells from the fat help with new growth of the fat pad

Dr Blake's comment:
     I was thinking the same, but as long as we get good results probably does not matter!

They are doing a volunteer study for the heel which I'm going to apply for so it's free. Worth a shot. I'll keep you posted in case it might help others. 

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.