The Center for Podiatric Care and Sports Medicine

NBA News: Kevin Durant Foot Implant Controversy

Posted by on Wednesday, September 23rd, 2015

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Kevin Durant is no stranger to our blog. We wrote about the Jones fracture in his right foot on October 22nd 2014. This February, we talked about his left toe sprain — and, a month later, we told you about his second Jones fracture surgery. Most recently, Oklahoma City’s star guard admitted that he had another “unknown broken bone” in his foot that required surgery in March!1http://bleacherreport.com/articles/2547417-kevin-durant-reveals-unknown-bone-break-in-foot-but-says-hes-healthy-now As NYC podiatrists, we have to wonder: will Kevin Durant’s foot ever heal? Durant says he is “healthy now” — thanks, in part, to a controversial foot implant not yet approved by the FDA.

Kevin Durant’s controversial foot implant has not been approved by the FDA. Image source: Wikimedia CC “Kevin Durant Feb 2014” by Keith Allison. Licensed under CC

Kevin Durant’s Foot Implant Surgery & Recovery: What’s Next?

Kevin Durant underwent a third foot surgery on March 31st, due to “signs of regression,” ending a 27-game season. A screw head irritated the cuboid bone connecting the foot and ankle, near the fifth metatarsal on the outside of the foot. “I had a crack in it,” Durant told Bleacher Report.

Durant added that he had to take controversial measures to widen the bone and avoid foot failure again. Surgeons used a bone-graft material not yet approved by the FDA for use in the foot to stimulate greater bone growth. Additional steps were taken to protect against overgrowth of bone, which necessitated a longer recovery.

“They stuffed some bone-graft thing in, and they pasted over the top of the area. That healed up in a couple of weeks,” Durant explained. “But then they stuck something else in there just to smooth it out and make sure it was thick. They did a lot.”

“I got like an extra layer of bone on the side of my foot that they put in there,” he added.

LA orthopedic surgeon Robert Klapper (who was not directly involved in treating Durant) surmised that the use of the bone graft was akin to “putting a belt on his pants—and suspenders.”

To get through his recovery with a positive frame of mind, he relied on the care of his mother and viewed his progress as being like winning a series of little “championships,” he said. “The first one was just to put a shoe on,” Durant explained. “The second one was just to walk with two shoes. The third one was to run on the treadmill.” Next he progressed to jogging, shooting, and dunking.

Six months later, Durant has been cleared to play on his “healed” bone. Will it break again, though? It very well could, as the bone will need another year to truly complete the healing process. After a year, the repaired foot should have greater integrity than before, allowing Kevin Durant to rebound like the Lopez twins, Pau Gasol, Michael Jordan, and others with metatarsal fractures, but the fact that he has already suffered complications leaves a big question to ponder.

Why Is Medtronic’s Bone Graft Controversial?

The “controversial” implant was Medtronic’s Infuse Bone Graft, which is currently only FDA approved for use in spinal fusion procedures, open tibial shaft fractures and oral-maxillofacial procedures.2http://www.massdevice.com/nba-star-treated-with-medtronic-infuse-graft-for-foot-break/ It combines recombinant human bone morphogenetic protein with cow collagen to initiate bone growth. The Infuse bone graft was first approved in 2002 for use in spinal fusion surgery in the lower lumbar region of the back, and at one time grossed nearly $1 billion in annual sales.

However, more than 182,000 lawsuits across the country accuse the company of downplaying the product’s risks and promoting the graft for off-label use, which has allegedly caused abnormal bone growth, cancer and male sterility.3http://www.drugwatch.com/infuse/ In 2008, the FDA issued a warning about serious complications after off-label use of Infuse in the cervical area of the spine, citing 200 adverse event reports in their database.4http://www.lawyersandsettlements.com/lawsuit/medtronic-infuse-bone-graft.html?utm_expid=3607522-8.5SJXq6u5QiKGWbPEoiq34w.0&utm_referrer=https%3A%2F%2Flive.healingfeet.com%2Fwp-admin%2Fpost.php%3Fpost%3D9134%26action%3Dedit#.VgMszRFVikp

Will Infuse Bone Grafts Be Used in NYC Foot Surgery?

Currently, little information exists about the controversial off-label use of the Infuse bone graft material in foot and ankle surgery. A 2010 review published in the journal Foot & Ankle Clinics summarized that, “Bone morphogenetic proteins (BMPs) have played an integral role in the advancement of tissue engineering strategies” and further posited that “BMPs have recently been applied in several areas of foot and ankle surgery, including acute fracture augmentation, nonunions, and arthrodesis, with promising results.”5http://www.ncbi.nlm.nih.gov/pubmed/21056855

In the absence of clinical trials that demonstrate safety, we do not currently use Medtronic’s product in our surgeries at The Center for Podiatric Care and Sports Medicine in NYC. We will, however, be keeping close watch on Mr. Durant’s progress and reading up on any new medical research coming out. Our centers continue to be on the leading edge of sports medicine with innovative treatments like Platelet Rich Plasma injections and Extracorporeal Shockwave Therapy. Yet, we always put safety first and only use FDA approved treatments backed by clinical data.

Contact us for more information on our NYC sports medicine therapies or NY foot and ankle services.

 

 

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1. http://bleacherreport.com/articles/2547417-kevin-durant-reveals-unknown-bone-break-in-foot-but-says-hes-healthy-now
2. http://www.massdevice.com/nba-star-treated-with-medtronic-infuse-graft-for-foot-break/
3. http://www.drugwatch.com/infuse/
4. http://www.lawyersandsettlements.com/lawsuit/medtronic-infuse-bone-graft.html?utm_expid=3607522-8.5SJXq6u5QiKGWbPEoiq34w.0&utm_referrer=https%3A%2F%2Flive.healingfeet.com%2Fwp-admin%2Fpost.php%3Fpost%3D9134%26action%3Dedit#.VgMszRFVikp
5. http://www.ncbi.nlm.nih.gov/pubmed/21056855

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.