American College of Foot and Ankle Surgeons Clinical Consensus Statement: Appropriate Clinical Management of Adult-Acquired Flatfoot Deformity

Piraino, Jason; Theodoulou, Michael H.; Mar-Ortiz, Julio; Peterson, Kyle S.; Lundquist, Andrew L.; Hollawell, Shane; Scott, Ryan T.; Joseph, Robert M.; Mahan, Kieran T.; Bresnahan, Philip J.; Butto, Danielle N.; Cain, Jarrett D.; Ford, Timothy C.; Knight, Jessica; Wobst, Garrett M.

doi:10.1053/j.jfas.2019.09.001

Cited by 7 publications

(4 citation statements)

References 68 publications

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“…In this review, the indication for LCL with a PTW was a flexible flat foot deformity for 100% (236/236) of the patients. LCL, as a joint-sparing procedure for flexible flat foot deformities, has shown favorable outcomes [1,23,24]. LCL procedures are often performed in conjunction with ancillary procedures to adequately address and correct the multiplanar flat foot deformity [1,14,23].…”

Section: Discussionmentioning

confidence: 99%

“…LCL, as a joint-sparing procedure for flexible flat foot deformities, has shown favorable outcomes [1,23,24]. LCL procedures are often performed in conjunction with ancillary procedures to adequately address and correct the multiplanar flat foot deformity [1,14,23]. Across all included studies, a cotton osteotomy was found to accompany an LCL most often (n = 92), followed by tendon transfer (n = 65), MDCO (n = 51), PTT debridement (n = 32), spring ligament repair (n = 29), posterior muscle group lengthening (n = 22), medial column fusion (n = 7), etc.…”

Section: Discussionmentioning

confidence: 99%

“…A flexible flatfoot deformity is a common condition characterized by a progressive collapse of the medial longitudinal arch of the foot [1]. It can be a debilitating condition resulting in significant pain, discomfort, and functional limitations for affected individuals.…”

Section: Introductionmentioning

confidence: 99%

“…Various surgical techniques have been developed to correct this flexible deformity and restore normal foot function [2,3]. One such technique is lateral column lengthening (LCL), a workhorse joint-sparing procedure for surgeons treating flexible flatfoot deformities [1,4]. LCL requires interposition grafting to achieve and maintain deformity following search criteria were performed: "Calcaneal lengthening osteotomy" AND "Flexible flatfoot" AND "Evans osteotomy" AND "Evans osteotomy graft" AND "Lateral column lengthening" AND "Porous titanium wedge".…”

Section: Introductionmentioning

confidence: 99%

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Outcomes and Complications Associated with Lateral Column Lengthening Using Porous Titanium Wedges for Flexible Flatfoot Deformity Correction: A Systematic Review

Zachary P,

Joseph R,

Ross T

et al. 2024

Int J Foot Ankle

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Numerous graft materials have been utilized and described to achieve deformity correction in lateral column lengthening procedures (LCL) including autograft, allograft, xenograft, and porous titanium wedges (PTW). PTWs offer a potentially advantageous substitute for traditional grafts. Evidence regarding outcomes and complications of these grafts remains limited. This systematic review aims to describe functional outcomes and complications associated with LCL using PTWs. A standard methodology for performing a systematic review was followed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. PubMed, Google Scholar, OVID, Embase, and Cochrane were searched. Publications with 1-year follow-up and LCLs performed with PTWs were included. Non-English articles and those that did not perform LCL with PTWs were excluded. 508 articles were identified. 7 studies met the inclusion criteria following our review. 246 LCLs (236 patients) using PTWs were reported. The Foot and Ankle Ability Measure Activities of Daily Living (FAAM-ADL) score measured at 80.45 (80.0-80.9) post-operatively. FAAM Sports subscale measured at 58.5 (50.0-66.9) postoperatively. VAS pain score decreased from 5.45 (5.0-5.9) pre-operatively to 2.43 (1.6-3.0) post-operatively. The total complication rate was found to be 15.2% (36/236). Major complications including non-union, reoperation, deep infection, and chronic regional pain syndrome (CRPS) were 2.1% (5/236). The evidence from this systematic review suggests that LCL with PTWs can be an effective and viable option for correcting flexible flatfoot deformities. The use of PTWs appears to offer comparable functional results and complication rates to traditional allograft or autograft wedges.

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