Patient-Based Outcomes After Clubfoot Surgery

Roye, Benjamin; Vitale, Michael G.; Gelijns, Annetine C.; Roye, David P.

doi:10.1097/00004694-200101000-00010

Cited by 46 publications

(48 citation statements)

References 58 publications

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“…The DSI score was introduced by Roye et al [17] and was validated by Dietz et al [20]. The latter [20] compared the DSI of 62 clubfoot patients after joint-invasive surgery and joint-sparing treatment at an age between five and 12 years.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 125 patients with 199 clubfeet met the inclusion criteria and were sent an invitation to participate in this study including a survey letter with the Pediatric Outcomes Data Collection Instrument (PODCI) [16] and the disease-specific instrument (DSI) questionnaire [17]. For patients not presenting for the examination, data of the last follow-up visit were extracted from the medical records.…”

Section: Methodsmentioning

confidence: 99%

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Midterm results of the Ponseti method in the treatment of congenital clubfoot

Radler

Mindler

Riedl

et al. 2013

International Orthopaedics (SICOT)

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Purpose The Ponseti method has become the gold standard for clubfoot treatment. Although promising short-term results have been published, only a few studies report results at the end of the bracing period. We aimed to evaluate the functional midterm results, rate of recurrence and need for subsequent surgery. Methods Patients from our prospective database of clubfeet treated with the Ponseti method with a minimum age of three years were identified. Exclusion criteria were syndrome or neurogenic association, address in a foreign country, presentation after six weeks of age, more than three casts applied elsewhere and correction with less than three casts. A total of 125 patients met the inclusion criteria. The Pediatric Outcomes Data Collection Instrument (PODCI), the disease-specific instrument (DSI) questionnaire and an invitation for a clinical examination were sent out. For patients not presenting for evaluation, data from the last follow-up were extracted. Results Seventy questionnaires (56 %) of patients with a mean age of 5.7 years (3.3-8.9 years) were returned. The DSI score (n=65) was 85.3 (± 13.01 SD) and the PODCI score (n=59) was 95.5 (± 6.3 SD). A total of 113 of 125 patients (90.4 %) with 182 clubfeet were examined in the study or seen in follow-up. During a mean follow-up of 5.2 years (range 3-8.5 years) a repeat tenotomy was performed in 4 % of cases, a percutaneous Achilles tendon lengthening in 3 %, a tibialis anterior tendon transfer in 13 % and open joint surgery in 5 %. The mean dorsiflexion with knee extended was 15.9°(range 0-32°; SD ±5.5) with 16 feet (9 %) presenting less than 10°. Conclusions The functional scores indicate that the Ponseti method results in mostly pain-free feet not limiting ageappropriate activity. In this consecutive case series open joint surgery could be avoided in 95 % of cases with a good functional and anatomic outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Midterm results of the Ponseti method in the treatment of congenital clubfoot

Radler

Mindler

Riedl

et al. 2013

International Orthopaedics (SICOT)

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“…Dobbs et al [10] used the SF-36 questionnaire [24]. We used the previously validated Roye et al [28] DSI to measure satisfaction outcomes. Our questionnaire showed major satisfaction of the parents with the results of treatment at average followup of 6.3 years.…”

Section: Discussionmentioning

confidence: 99%

“…We measured parents' satisfaction regarding their children's feet using a 10-item clubfoot Disease Specific Instrument (DSI) as described by Roye et al [28] (Appendix 1). The parents of 68 patients answered the clubfoot DSI.…”

Section: Methodsmentioning

confidence: 99%

Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

Bor

Coplan

Herzenberg

2009

Clinical Orthopaedics &Amp; Related Research

140

117

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Ponseti clubfoot treatment has become more popular during the last decade. We reviewed the medical records of 74 consecutive infants (117 club feet) who underwent Ponseti treatment. Minimum followup was 5 years (mean, 6.3 years; range, 5-9 years). We studied age at presentation, previous treatment, the initial severity score of the Pirani scoring system, number of casts, need for Achilles tenotomy or other surgical procedures, and brace use. We measured final ankle motion and parents' perception of outcome. Late presentation and previous nonPonseti treatment were associated with lower initial severity score, fewer casts, and less need for tenotomy.

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“…Function and satisfaction were assessed using the diseasespecific instrument for clubfoot questionnaire [3,22], and quality of life was assessed using the Infant Toddler Quality of Life Questionnaire TM (www.healthact.com/itqol.php) [18].…”

Section: Outcome Measuresmentioning

confidence: 99%

Is Tibialis Anterior Tendon Transfer Effective for Recurrent Clubfoot?

Gray

Burns

Little

et al. 2013

Clin Orthop Relat Res

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Background Tibialis anterior tendon transfer surgery forms a part of Ponseti management for children with congenital talipes equinovarus who, after initial correction, present with residual dynamic supination. Although retrospective studies support good outcomes, prospective longitudinal studies in this population are lacking. Questions/purposes We assessed strength, plantar loading, ROM, foot alignment, function, satisfaction, and quality of life in patients with clubfoot that recurred after Ponseti casting who met indications for tibialis anterior tendon transfer surgery, and compared them with a group of patients with clubfoot treated with casting but whose deformity did not recur (therefore who were not indicated for tibialis anterior tendon transfer surgery).Methods Twenty children with idiopathic congenital talipes equinovarus indicated for tibialis anterior tendon transfer surgery were recruited. Assessment at baseline (before surgery), and 3, 6, and 12 months (after surgery) included strength (hand-held dynamometry), plantar loading (capacitance transducer matrix platform), ROM (Dimeglio scale), foot alignment (Foot Posture Index Ó ), function and satisfaction (disease-specific instrument for clubfoot), and quality of life (Infant Toddler Quality of Life Questionnaire TM ). Outcomes were compared with those of 12 age-matched children with congenital talipes equinovarus not indicated for tibialis anterior tendon transfer surgery. Followup was 100% in the control group and 95% (19 of 20) in the tibialis anterior transfer group. Results At baseline, the tibialis anterior tendon transfer group had a significantly worse eversion-to-inversion strength ratio, plantar loading, ROM, foot alignment, and function and satisfaction. At 3 months after surgery, eversion-to-inversion strength, plantar loading, and function and satisfaction were no longer different between groups. Improvements were maintained at 12 months after surgery (eversion-to-inversion strength mean difference, 8% body weight; 95% CI, À26% to 11%; p = 0.412; plantar loading, p [ 0.251; function and satisfaction, p = 0.076). ROM remained less and foot alignment more supinated in the tibialis anterior tendon transfer group between baseline and followup (p \ 0.001, p \ 0.001). Conclusions Tibialis anterior tendon transfer surgery was an effective procedure, which at 12-month followup restored the balance of eversion-to-inversion strength and resulted in plantar loading and function and satisfaction outcomes similar to those of age-matched children with congenital talipes equinovarus who after Ponseti casting were not indicated for tibialis anterior tendon transfer.

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Patient-Based Outcomes After Clubfoot Surgery

Cited by 46 publications

References 58 publications

Midterm results of the Ponseti method in the treatment of congenital clubfoot

Midterm results of the Ponseti method in the treatment of congenital clubfoot

Ponseti Treatment for Idiopathic Clubfoot: Minimum 5-year Followup

Is Tibialis Anterior Tendon Transfer Effective for Recurrent Clubfoot?

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