Return to sport activities after subtalar arthroereisis for correction of pediatric flexible flatfoot

Martinelli, Nicolò; Bianchi, Alberto; Martinkevich, Polina; Sartorelli, Elena; Romeo, Giovanni; Bonifacini, Carlo; Malerba, Francesco

doi:10.1097/bpb.0000000000000449

Cited by 33 publications

(65 citation statements)

References 26 publications

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“…Martinelli et al reported 49 pediatric patients treated with insertion of a permanent implant in the sinus tarsi. 24 A total of 91.8% of these patients returned to normal sports activities after surgery. Needleman treated 28 feet of 23 adult patients with subtalar arthrodesis by sinus tarsi implant, and the occurrence of sinus tarsi discomfort was as high as 42% after implantation.…”

Section: Discussionmentioning

confidence: 93%

Total talar replacement with a novel 3D printed modular prosthesis for tumors

Fang¹,

Liu²,

Xiong³

et al. 2018

TCRM

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PurposeArthrodesis is one of the most widely accepted surgical recommended methods for tumors of the talus, but it may be associated with poor limb functions. The aim of this study was to present a novel reconstruction with ankle function preserved after en bloc talus tumor resection.Patient and methodA 43-year-old female with mesenchymal sarcoma of the talus was admitted in West China Hospital. Total talar replacement with three-dimensional (3D) printed modular prosthesis was prepared for reconstruction. The 3D printed modular prosthesis was designed exactly as the mirror image of the contralateral talus with complete filling of the sinus tarsi and subtalar joint space. The upper modular component of prosthesis was made of ultra high molecular weight polyethylene, and the lower component, titanium alloy. Pre-drilled holes in three directions were prepared for screw fixation of the subtalar joint.ResultsThe patient underwent en bloc talus resection through anterior approach, followed by reconstruction with the 3D printed prosthesis. The whole procedure took 2 hours, and intra-operative blood loss was 50 mL. At the last follow-up, our patient was disease free and she could walk almost normally without any aid or pain. The Musculoskeletal Tumor Society score was 26/30. The American Orthopedic Foot and Ankle Society score was 91/100. The range of motion for dorsiflexion and plantar flexion was 40°. And no abnormalities were observed in the roentgenograph.ConclusionTotal talar replacement with a 3D printed modular prosthesis may be an effective procedure for patients with tumors of the talus as it could maintain ankle function.

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Section: Discussionmentioning

confidence: 93%

Total talar replacement with a novel 3D printed modular prosthesis for tumors

Fang¹,

Liu²,

Xiong³

et al. 2018

TCRM

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show abstract

“…They found that duration, frequency, and type of sporting activities did not change after a surgical subtalar procedure. 39 Previous studies on patient satisfaction after treatment with a subtalar arthroereisis only reported satisfaction directly postoperatively in an adult population or with other subtalar arthroereises. 14,18,24,40 The present study is one of the few studies that extensively assessed patient satisfaction in children at a mean follow-up period of 47 months after treatment with the Kalix II implant.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiological Outcomes of Subtalar Kalix II Arthroereisis for a Symptomatic Pediatric Flexible Flatfoot

Bot

Stevens

Hermus

et al. 2019

Foot & Ankle Specialist

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Background. The purpose of this study is to evaluate functional and radiological outcomes of subtalar arthroereisis in the treatment of symptomatic pediatric flexible flatfeet. Methods. A total of 16 patients (26 feet) were treated with a Kalix II as subtalar motion blocker between 2009 and 2014. Calcaneal pitch (CP) and Meary’s angle (MA) were measured on radiographs preoperatively, directly postoperatively, and at follow-up 47 ± 17 (range 19-79) months. Patient satisfaction surveys were used to assess functional outcome and patient satisfaction. Results. Surgery was performed mostly for pain, walking problems, or a combination of both at a mean age of 12.5 ± 1.5 (range 10-15) years. Symptoms were relieved in 62.5% of patients in the postoperative phase and increased to 68.75% at follow-up. A statistically significant increase in CP of 2.8° and decrease in MA of 14.0° was observed directly postoperatively, which persisted during the follow-up period irrespective of Kalix removal. Revision surgery was necessary in 6 cases (23%) because of arthroereisis migration. Conclusion. Subtalar Kalix II arthroereisis significantly reduced clinical symptoms and improved the CP and MA directly postoperatively, which persisted during follow-up, irrespective of Kalix removal. Therefore, subtalar arthroereisis is a considerable intervention to reduce symptoms in children with symptomatic flexible flatfeet. Levels of Evidence: Level IV: Case series

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“…There are numerous studies that have provided the evidence basis, safety and effectiveness of this minimally invasive joint sparing procedure. There is evidence of radiographic normalization of osseous realignment (86,87), restoration of navicular height/position (88), maintenance of arch height (89,90), restoration of joint congruity (3), rebalancing of subtalar joint forces (91), decreased strain to the plantar fascia (92), posterior tibial nerve (93), and tendon (94), improved function and pain scores (95), improved ankle joint alignment (96), return to sports activity, and improved emotional status (97). Pediatric patients report a high degrees of satisfaction, and their quality of life was improved and not compromised by the procedure (98,99).…”

Section: Conservative Surgical Treatmentmentioning

confidence: 99%

Pediatric Flatfeet—A Disease Entity That Demands Greater Attention and Treatment

Bresnahan

Juanto

2020

Front. Pediatr.

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Background: Pediatric flatfoot is a common deformity. Unfortunately, the common opinion has been that most children with this faulty foot structure will simply out-grow it, despite no radiographic evidence to support this claim. Every step on a deformed foot leads to excessive tissue strain and further joint damage. Many forms of conservative and surgical treatments have been offered. This study was aimed at investigating the effectiveness of non-surgical and surgical treatment options.Main Text: faulty-foot structure is the leading cause of many secondary orthopedic deformities. A wide range of treatments for pediatric flatfeet have been recommended from the “do-nothing” approach, observation, to irreversible reconstructive surgery. Most forms of conservative care lack evidence of osseous realignment and stability. A conservative surgical option of extra-osseous talotarsal joint stabilization provides patients an effective form of treatment without the complications associated with other irreversible surgical procedures.Conclusion: Pediatric flatfeet should not be ignored or downplayed. The sooner effective treatment is prescribed, the less damage will occur to other parts of the body. When possible, a more conservative corrective procedure should be performed prior to irreversible, joint destructive options.

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Return to sport activities after subtalar arthroereisis for correction of pediatric flexible flatfoot

Cited by 33 publications

References 26 publications

Total talar replacement with a novel 3D printed modular prosthesis for tumors

Total talar replacement with a novel 3D printed modular prosthesis for tumors

Clinical and Radiological Outcomes of Subtalar Kalix II Arthroereisis for a Symptomatic Pediatric Flexible Flatfoot

Pediatric Flatfeet—A Disease Entity That Demands Greater Attention and Treatment

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