What is the Role of Podiatric Surgery in the Elderly Patient?
– Profile of patient age, type and need for foot surgery in Australia
Within the next decade, Australia will have over 5 million residents aged over 65 years. Foot pain, foot deformities and arthritis are more common late in life and prediction are that within the next decade over 1.3 million older Australians will be living with foot pain. Foot and ankle problems in particular Hallux valgus and hammer toes associated with decreased plantar tactile strength increase the risk of falls in older people. While research has shown multifaceted podiatry interventions can produce significant reductions in falls rate, to date there has been no studies to look at the potential role of foot surgery in falls prevention.
Hallux valgus and hammer toes are a progressive deformity which are often do not cause significant functional problems until later in life which raises the question should we be considering surgical correction of these deformities at a younger age?
Conservative therapies are a priority when addressing the geriatric population, but surgical options may be overlooked secondary to a misunderstanding of their ability to overcome perioperative management so there is a tendency to shy away from presenting surgical options, the common belief being “too old,” “too risky,” “won’t heal” and “just live with it.”
The need for foot surgery increases with age so perioperative assessment and screening of patients is an important component of assessing suitability and surgical management of the elderly patient. Not all foot surgery needs to be complex, risky or have a long convalescence. There is a range of simple surgical procedures, commonly overlooked that can be performed safely under local anesthesia on a day surgery basis that can provide a significant reduction in foot pain and improvement in quality of life.
Presented by:
Andrew has a very broad and varied career in the 41 years since his graduation in 1981. After a period at Finders Medical Centre he started his surgical training gaining his Fellowship of the Australasian College of Podiatric Surgeons and endorsement for scheduled in 1995. He also holds Fellowships with the Australian Sport Medicine Federation and Academy of Minimally Invasive Foot and Ankle Surgery (USA). In 2016 was awarded a Fellowship in the prestigious Faculty of Podiatric Medicine at the Royal College of Physicians and Surgeons (Glasgow).
He has previously helped develop the curriculum and lectured in postgraduate courses including surgery, paediatrics, advanced biomechanics, advanced podiatric medicine and sports medicine. He has lectured in Japan extensively since 1995 and continues to do so annually. Other work overseas includes developing a program for the early intervention and treatment of clubfoot in Vietnam.
He has been accredited at various private hospitals and held a public hospital position as a Visiting Podiatric Surgeon at the Repatriation General Hospital from 2002 – 2010.
Other professional activities have included state and national president of the Australian Podiatry Association, chairperson of the Podiatrist’s Registration Board of South Australia, Trustee of the Australian Academy of Podiatric Sports Medicine, chairman of the Australian Podiatry Education and Research Foundation, council member of the Australasian College of Podiatric Surgeons and numerous other professional committees and boards.
Andrew is currently consulting and operating in his private practice, My Foot Surgeon in both South Australia, and Northern Territory. He provides guest lectures and clinical supervision at the University of South Australia and is a practitioner member on the Podiatry Board of Australia. His future projects are to improve health outcomes by increased access to podiatric surgery for remote first nations communities in the Northern Territory.
Outside of podiatry Andrew has been a dedicated runner having completed in the New York and Paris Marathons and many local events. Sailing is his main sport participating in multiple Sydney Hobarts, The Fastnet Race in the UK, national and international regattas. Andrew is a keen supporter of the Arts and has a high level of engagement through his wife who is the CEO of Restless Dance Theatre.