Pros and Cons of the Subtalar Joint Arthroereisis Procedure in Pediatric Flatfoot Deformity

NewsBot · May 30, 2024

Gait Analysis in Patients with Symptomatic Pes Planovalgus Following Subtalar Arthroereisis with the Talus Screw
Andrzej Bobiński et al
Indian J Orthop. 2024 Mar 11;58(6):696-704

Background: Pes planovalgus is one of the most common pediatric skeletal deformities. There have been no studies to analyze in detail the spatiotemporal variables of gait following arthroereisis.

Purpose of the study: The purpose of our study was to assess gait parameters in patients with symptomatic flexible flatfoot following treatment with the talus screw.

Methods: This was a prospective study assessing the 22 patients treated surgically due to symptomatic flexible flatfoot with the talus screw. Patients underwent gait assessment with a G-Sensor. We analyzed the following gait parameters: gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, cadence, velocity, step length.

Results: The post-operative gait parameter assessment for the operated and non-operated foot showed a significant difference only in terms of step length. Cadence increased from the pre-operative mean of 82.29 steps/min to a post-operative mean of 102.94 steps/min. Gait velocity increased significantly from 0.81 m/s before to 0.96 m/s after surgery.

Discussion: Arthroereisis with the talus screw helps improve gait parameters following surgery. Post-operatively, we observed increased gait velocity and cadence and decreased gait cycle duration in the operated limb.
Click to expand...

NewsBot · May 31, 2024

Clinical outcomes of subtalar arthroereisis for the treatment of stage 1 flexible progressive collapsing foot deformity
Thomas L Lewis et al
Eur J Orthop Surg Traumatol. 2024 May 30

Background: The use of subtalar arthroereisis as an adjunct to the surgical treatment of stage 1 flexible progressive collapsing foot deformity (PCFD) is controversial. The aim was to investigate the clinical outcomes and report the implant removal rate of subtalar arthroereisis as an adjunct for stage 1 PCFD.

Methods: A retrospective study of 212 consecutive feet undergoing operative management of stage 1 PCFD with adjunctive subtalar arthroereisis between October 2010 and April 2018. The primary outcome was the Foot and Ankle Outcome Score (FAOS). Secondary outcomes included Foot and Ankle Disability Index (FADI), Euroqol-5D-5L Index and implant removal rate.

Results: Post-operative clinical FAOS outcomes were collected for 153 feet (72.2%). At mean 2.5-year follow-up, the mean ± standard deviation FAOS for each domain was as follows; Pain: 81.5 ± 18.5, Symptoms: 79.5 ± 12.9, Activities of Daily Living: 82.5 ± 15.4 and Quality of Life: 64.2 ± 23.7. EQ-5D-5L Index was 0.884 ± 0.152. Pre-operative scores were available for 20 of these feet demonstrating a statistically significant improvement in all FAOS, FADI and EQ-5D-5L domains (p < 0.05). The implant removal rate for persistent sinus tarsi pain was 48.1% (n = 102).

Conclusion: Use of a subtalar arthroereisis implant as an adjunct to conventional procedures in stage 1 flexible PCFD can result in significant improvement in pain and function. Patients should be counselled as to the relatively frequent rate of subsequent implant removal.
Click to expand...

NewsBot · Jun 28, 2024

Effects of subtalar arthroereisis in children, assessed on the basis of quality-of-life questionnaires
Kamila Pardus et al
Ann Agric Environ Med. 2024 Jun 27;31(2):272-278.

Introduction and objective: Subtalar arthroereisis is a procedure commonly performed in children with flat feet. The procedure is performed when conservative treatment did not have the desired effect,or when the patient's abnormal symptoms are very severe and make it difficult for them to function normally in daily life. The aim of this study was to assess whether subtalar arthroereisis and physiotherapy improve the quality of life among children with flat feet.

Material and methods: The study comprised 79 patients (140 operated feet) diagnosed with a flat foot defect who underwent a subtalar arthroereisis procedure. A self-administered questionnaire and a shortened version of the standardised WHOQOL-BREF questionnaire were used in the research.

Results: The study confirmed that the patients' quality of life after surgery was high in all the areas regarding the somatic, psychological, social and environmental domains. In the group of children assessed 13-24 months after surgery. it was also found that rapid fatigue after exercise (30% ± 9%) and Achilles tendon contracture (7% ± 4%) were significantly reduced. The results of the study confirmed that subtalar arthroereisis contributes to a decreased demand for orthoses in children (9% ± 6%) and for orthopaedic footwear (11% ± 5%) than before surgery.

Conclusions: The employment of subtalars arthroereisis has a positive effect on the quality of life of children with flat feet. The surgery contributes to a reduction in pain and other abnormal symptoms that are associated with flat feet. In addition, physiotherapy performed after the procedure had a positive effect on the healing process and contributed to the improvement of the children's quality of life.
Click to expand...

NewsBot · Jun 28, 2024

Subtalar arthroereisis with metallic implant is a safe and effective treatment for pediatric patients with symptomatic flexible flatfeet. A 10-year clinical and radiographic follow-up.
Giacomo Moraca et al
Foot and Ankle Surgery; 27 June 2024

Background
Subtalar arthroereisis (SA) is an increasingly applied minimally invasive approach for flexible flat foot (FFF) not responsive to conservative treatment. This study aimed at evaluating the long-term clinical and radiographic outcomes of SA in pediatric patients with symptomatic FFF.

Methods
Thirty-seven patients (11.9±1.6yy) underwent SA (74 feet), with outcomes assessed after a mean 10-year follow-up. Pain, quality of life, foot functionality, and alignment were evaluated using validated tools and radiographic parameters, calculated on weightbearing x-rays pre- and post-operatively.

Results
Clinical outcomes reached excellent postoperative results (FFI: 9.1, AOFAS: 94.5) with a low 0.9 NRS pain (p<0.01) and a 92% satisfaction. All radiographic parameters improved significantly towards normal values: CP 17.5±3.9, MA 4.3±5.8, TCA 42.8±6.2, TNCA 21.1±8.5, TNU% 26.6±8.4 (all p<0.01).

Conclusions
SA with a metallic endosinotarsal device provided significant long-term clinical and radiographic improvements, with low complication rates and high patient satisfaction, supporting its efficacy as a treatment option for pediatric symptomatic FFF.
Click to expand...

NewsBot · Jul 31, 2024

Do First Ray-Related Angles Change following Subtalar Arthroereisis in Pediatric Patients? A Radiographic Study
Antonio Mazzotti et al
Children (Basel). 2024 Jun 22;11(7):760

Introduction: Subtalar Arthroereisis (STA) is a surgical intervention for pediatric flexible flatfoot (PFF), primarily targeting hindfoot alignment by limiting excessive subtalar eversion. However, its effects on forefoot parameters remain underexplored. This study aims to investigate radiological changes following STA in pediatric patients.

Materials and methods: A retrospective analysis was conducted on consecutive patients treated with STA for PFF. First ray-related angles, including the Hallux Valgus Angle (HVA) and the Intermetatarsal Angle (IMA), alongside hindfoot radiological parameters such as the Meary, Calcaneal Pitch, and Costa Bartani angles, were assessed. Subgroup analysis by gender was performed, and correlations between demographic and preoperative radiological parameters were examined.

Results: Forty-one patients (81 feet) with an average age of 11.6 years were included, with a mean follow-up duration of 6.4 months. No significant differences were observed in first ray-related angles pre-and postoperatively, with the mean IMA changing from 7.97° to 7.18° and the mean HV angles changing from 9.51° to 8.66°. Noteworthy improvements were seen in flat foot angles, including the Meary, Calcaneal Pitch, and Costa Bartani angles, postoperatively. The age subgroup analysis revealed similar trends in IMA and HVA changes between Group A (who underwent surgery before peak growth) and Group B (who underwent surgery after peak growth). Higher preoperative angles tended to improve, while lower preoperative IMAs and HVAs tended to worsen postoperatively, all remaining within normal ranges.

Conclusion: STA showed positive radiological outcomes for PFF treatment, while negligible changes in first ray-related angles were observed. The age subgroup analysis indicated similar trends regardless of operation timing. Higher preoperative angles tended to improve, while lower preoperative angles tended to worsen postoperatively, despite all falling within non-pathological ranges. Further research is warranted to confirm this correlation
Click to expand...

NewsBot · Oct 4, 2024

Pediatric flexible flatfoot: Does obesity influence the outcomes of arthroereisis?
Luca Monestier et al
World J Orthop. 2024 Sep 18;15(9):850-857

Background: Childhood obesity has emerged in the last decades as an important public health problem worldwide. Although relationships between obesity and flatfoot have been shown, no studies have investigated the influence of obesity on arthroereisis outcomes.

Aim: To evaluate correlations between childhood overweight/obesity and clinical and radiographic outcomes after subtalar arthroereisis with self-locking implants.

Methods: This retrospective study included one hundred and sixty-nine pediatric patients (10-14 years old) who underwent subtalar arthroereisis (PEEK PitStop® device) for severe flexible flatfoot. Exclusion criteria were additional procedures, revision of previous corrective surgeries, rigid flatfoot with severe deformity, and neurological or post-traumatic flatfoot. Preoperative/postoperative European Foot and Ankle Society (EFAS) and visual analogue scale (VAS) scores were determined; radiographic assessment was conducted on weight-bearing foot X-rays: Kite angle, first metatarsal-talus angle, Meary angle, calcaneal pitch angle and lateral talo-calcaneal angle were analyzed.

Results: EFAS and VAS scores improved post-operatively in the whole population. Only seven cases with complications were reported. Radiographic assessment revealed an improvement in all angles. Statistical analysis demonstrated that the impact of obesity was significant on arthroereisis outcomes: Relationships were reported between BMI and postoperative EFAS/VAS scores, postoperative calcaneal pitch angle, Kite angle, Meary angle and talo-first metatarsal angle.

Conclusion: Although arthroereisis represents a very effective and valid treatment for flatfoot both in normal weight and obese children, obesity significantly influences clinical and radiographic outcomes of arthroereisis, and obese children tend to perceive more pain and discomfort.
Click to expand...

NewsBot · Oct 18, 2024

Simultaneous subtalar arthroeresis, midfoot soft tissue release, and talo-navicular arthrodesis in children with planovalgus neurologic foot
Marco Corradin, Roberto Schiavon, Andrea Micaglio, Silvia Pierantoni, Valentina Luppi & Federico Canavese
European Journal of Orthopaedic Surgery & Traumatology

Purpose
Planovalgus foot deformity (PVFD) is common in children with neuromuscular conditions and severe deformity may require surgical correction. This study aims to assess clinical and radiological outcomes of PVFD secondary to neuromuscular disease managed by subtalar arthroeresis (SuAE), midfoot soft tissue release and talo-navicular arthrodesis (TNA).

Methods
A retrospective analysis of children with neuromuscular disease and nonreducible PVFD who underwent SuAE, midfoot soft tissue release, and TNA and with a minimum follow-up of 5 years was performed. A total of 60 patients with neuromuscular disease (108 feet) including cerebral palsy were reviewed. Mean age at surgery was 12.7 ± 4.6 years (6–17). Mean follow-up was 7 ± 2.9 years (5–10). Clinical outcomes and radiologic correction at final follow-up were compared with preoperative values. Statistical analysis was performed and significance was set at P < 0.01.

Results
Statistically significant radiological improvements between pre- and postoperative values were found for all angle values. At final follow-up, there was a significant improvement in VAS score (4.8 vs. 2; P < 0.01). There was also a positive trend in the improvement of walking ability. No cases of pseudoarthrosis were reported at final follow-up. Screw removal was required in 5 out of 108 feet (4.6%) and 2 feet (3.3%) had delayed medial wound healing.

Conclusions
SuAE combined with TNA and midfoot soft tissue is a safe and feasible procedure that can provide good clinical and radiologic results in patients with neuromuscular disease and nonreducible PVFD; the procedure can improve foot stability, and has a limited number of complications.
Click to expand...

NewsBot · Oct 27, 2024

Long-Term Results of Subtalar Arthroereisis for Symptomatic Flexible Flatfoot in Pediatrics
Jou-Hua Wang, Chia Hung Chu, Hao-Chun Chuang, Yan Yu Chen
Source

Purpose:
Subtalar arthroereisis (STA) is a clinical intervention used for the correction of flexible flatfoot (FFF) in the pediatric population. This study aims to evaluate the radiographic, clinical, and patient-reported outcomes of STA for symptomatic FFF in pediatric patients with a minimum follow-up period of nine years.

Methods:
A cohort of 19 patients (38 feet) who underwent STA for FFF treatment between 2011 and 2015 was analyzed. This study featured a minimum follow-up period of nine years and involved comprehensive radiographic measurements. Clinical function assessment included footprint analysis classified using the Viladot classification, the Foot and Ankle Outcome Score (FAOS), and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. We calculated the association between preoperative and postoperative angles and functional results. Receiver operating characteristic (ROC) curve analyses were conducted to establish the optimal threshold to predict good clinical outcomes.

Results:
The average age at the time of surgery was 11 ± 1.79 years, and the mean duration of follow-up was 10 ± 1.4 years. After the surgical intervention, all foot angles showed statistically significant improvements. Normal foot alignment according to the Viladot classification was noted in 71% of patients. Good to excellent functional outcomes, as measured by both the AOFAS-hindfoot score and FAOS score, were reported in 84.2% of patients. Significant correlations were found between the preoperative and postoperative angles and functional results. Based on ROC curve analysis, the cut-off values were determined to be 28.5 degrees for the talonavicular coverage angle, 19.5 degrees for Meary’s angle, and 37.5 degrees for the talar declination angle.

Conclusion:
Our study indicates that STA is an effective procedure for durable deformity correction in pediatric patients with FFF. Restoring the medial longitudinal arch and correcting forefoot abduction are essential for improving functional outcomes. Both preoperative and postoperative angles were significantly associated with functional results, and the identified preoperative cut-off values are helpful for selecting surgical candidates.
Click to expand...

NewsBot · Nov 8, 2024

HyProCure for Flatfoot Deformity: A Clinical Characteristics Analysis in China
Shaoling Fu et al
Orthop Surg. 2024 Nov 6

Background: Flatfoot is a common foot disorder involving progressive foot deformity of the three-dimensional structures of the forefoot, midfoot, and hindfoot. Currently, Chinese surgeons and patients favor subtalar arthroereisis (SA) due to its minimally invasive and low-damage characteristics. HyProCure device is widely used. However, there is limited analysis of large sample sizes. This study utilized statistical evaluation with a large sample size to analyze clinical characteristics trends of SA for flatfoot, including baseline indicators, selection of HyProCure size and surgical strategy, complications, and implant removal. This study will enhance the understanding of SA in China.

Methods: A retrospective analysis of 732 patients (1008 ft) who underwent SA from June 2015 to June 2023, with 509 pediatric and adolescent patients (772 ft) and 223 adult patients (236 ft). Based on the patient's age, patients aged ≤ 18 were included in the children and adolescent group, while adult acquired flatfoot deformity (AAFD) patients aged > 18 were included in the adult group. General data was collected, including patient sex, age, side, body mass index (BMI), surgery date, HyproCure size, and surgical data, and trends were analyzed. Postoperative complications and HyProCure removal were collected as outcome measures during follow-up.

Results: The age of patients treated with SA was gradually getting younger, with male patients predominating, mainly concentrated in the 11-14 age group. HyProCure 7 has the highest usage rate. In the children and adolescent group, 288 ft (37.31%) only underwent SA. In the adult group, 18 ft (7.63%) only underwent SA. Complications include sinus tarsi pain, peroneal spasms, achilles tendon tension, and muscle strength decline. The complication rate in the children and adolescent group was 5.05%, while in the adult group it was 28.81%. Overall, it was 10.62%. The removal rate of HyProCure in the children and adolescent group is 1.04%, in the adult group is 15.25%, and overall is 4.37%.

Conclusions: The trend in flatfoot treated with SA was towards children and adolescent male patients, and sinus tarsi pain was the most common complication after SA. The complication rate and removal rate in the children and adolescent group were lower than those in the adult group. HyProCure can be removed without additional adverse effects
Click to expand...

NewsBot · Dec 2, 2024

Subtalar Arthroereisis for
Symptomatic Flexible Flatfoot in
Adolescents: A Prospective Study of
26 Feet
Mohammad Alkhatatba et al
Source

Background: Flexible flatfoot is a normal finding
in infants and the arch is shaped spontaneously
in most children before the age of 10 years. Flexible flatfoot is a common deformity in both adolescent and adult populations. Objective: This
prospective study aims to assess the functional
and radiological outcomes of subtalar arthroereisis in adolescent patients with symptomatic
flexible flatfoot. Methods: This is a prospective
study and included 26 feet in 19 patients who
underwent subtalar arthroereisis for symptomatic flexible flatfeet deformity. Preoperative
and postoperative functional assessment based
on the American Orthopedic Foot and Ankle
Society (AOFAS) hindfoot scale. Radiographic
parameters included preoperative and postoperative Kite`s angle, talonavicular coverage
angle, Anterior-Posterior talo-1st metatarsal
angle, Meary`s angle, talar declination angle,
calcaneal inclination angle and lateral talocalcaneal angle. Results: The mean follow-up
period was 22.5±9.4 months and the mean
preoperative AOFAS score was 54.6±6.0, while
the mean AOFAS score at the last follow-up visit
was 86.3±3.9 (P<0.001).The mean preoperative
and postoperative radiological measurements
were 19.0°±8.2° and 7.4°±3.9° for the AP Talo1st metatarsal angle (P<0.001); 23.6°±9.1° and
8.0°±4.0° for talonavicular coverage angle
(P<0.001); 35.4°±3.7° and 24.1°±3.4° for Kite`s
angle (P<0.003); 22.4°±6.1° and 7.5°±3.7° for
Meary`s angle (P<0.001); 41.0°±4.4° and
25.2°±7.1° for talar declination angle (P<0.001);
13.5°±3.7° and 21.3°±3.6° for calcaneal inclination angle (P<0.001) and 52.4°±7.2° and
42.9°±4.8° for lateral talocalcaneal angle
(P<0.041) respectively. Conclusion: Subtalar arthroereisis is an effective and minimally invasive
procedure that showed clinical and radiological
improvement for symptomatic flexible flatfoot
in our study group
Click to expand...

NewsBot · Dec 6, 2024 at 5:45 AM

Subtalar arthroereisis with metallic implant is a safe and effective treatment for pediatric patients with symptomatic flexible flatfeet. A 10-year clinical and radiographic follow-up
Giacomo Moraca et al
Foot and Ankle Surgery; 27 June 2024

Background
Subtalar arthroereisis (SA) is an increasingly applied minimally invasive approach for flexible flat foot (FFF) not responsive to conservative treatment. This study aimed at evaluating the long-term clinical and radiographic outcomes of SA in pediatric patients with symptomatic FFF.
Methods
Thirty-seven patients (11.9 ± 1.6yy) underwent SA (74 feet), with outcomes assessed after a mean 10-year follow-up. Pain, quality of life, foot functionality, and alignment were evaluated using validated tools and radiographic parameters, calculated on weightbearing x-rays pre- and post-operatively.
Results
Clinical outcomes reached excellent postoperative results (FFI: 9.1, AOFAS: 94.5) with a low 0.9 NRS pain (p < 0.01) and a 92 % satisfaction. All radiographic parameters improved significantly towards normal values: CP 17.5 ± 3.9, MA 4.3 ± 5.8, TCA 42.8 ± 6.2, TNCA 21.1 ± 8.5, TNU% 26.6 ± 8.4 (all p < 0.01).
Conclusions
SA with a metallic endosinotarsal device provided significant long-term clinical and radiographic improvements, with low complication rates and high patient satisfaction, supporting its efficacy as a treatment option for pediatric symptomatic FFF.
Click to expand...

Pros and Cons of the Subtalar Joint Arthroereisis Procedure in Pediatric Flatfoot Deformity

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Pros and cons

pros and cons of being a podiatrist?

Pros and Cons of Pressure in Foot Orthosis Design

Chair Pros and Cons

Agency work in UK- pros and cons?

Pros or Cons of cutting the Peroneal Tendon

Pros and Cons of DC wedge orthoses

Share This Page

Pros and Cons of the Subtalar Joint Arthroereisis Procedure in Pediatric Flatfoot Deformity

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Pros and cons

pros and cons of being a podiatrist?

Pros and Cons of Pressure in Foot Orthosis Design

Chair Pros and Cons

Agency work in UK- pros and cons?

Pros or Cons of cutting the Peroneal Tendon

Pros and Cons of DC wedge orthoses

Share This Page

Useful Searches