The role of arthroereisis of the subtalar joint for flatfoot in children and adults

Bernasconi, Alessio; Lintz, François; Sadile, Francesco

doi:10.1302/2058-5241.2.170009

Cited by 69 publications

(109 citation statements)

References 74 publications

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“…Second, several complications are observed in subtalar arthroereisis, including malposition, overcorrection, undercorrection, wrong implant size, loss of position, persistent sinus tarsi pain, and tenderness. 14,[17][18][19][20][21]23,45 In our series, 6 cases (ie, 23%) out of 26 feet needed revision surgery. In all cases, the patients suffered from sinus tarsi pain and showed based on radiological evaluation subtalar arthroereisis displacement or migration compared to the postoperative radiographs and therefore reinsertion was necessary.…”

Section: Discussionmentioning

confidence: 58%

“…15,18,19,23,24,38 Finally, previous studies and reviews propose the scarcity of prospective comparative studies of the different interventions in current evidence. 8,25,45 This is a major limitation and might partly be the consequence of differences in invasiveness and the irreversibility of the available techniques as well as the accompanying ethical considerations, especially because it concerns research in pediatric populations. Retrospective studies on clinical effectiveness, reporting patient satisfaction and radiological and clinical outcomes are, therefore, still relevant.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 58%

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

View full text Add to dashboard Cite

show abstract

“…The mean age at treatment was 11.8 years (9-17): 11.6 (9-17) for the nonoperative group and 12.2 (10)(11)(12)(13)(14)(15) for the operative group There were no correlations between AOFA-AHS at baseline and sex, age, bilaterality, radiografic features. In all cases, the area of the coalition involved less than 50% of the subtalar joint and no radiographic OA was observed.…”

Section: Resultsmentioning

confidence: 87%

“…(10,11)Compared to FFF, RFF is most frequently symptomatic. (12) Pain is present in about 25% of cases; symptoms generally start in the second decade of life, when the coalition ossifies. (2,9) The management of symptomatic RFF with TCC is controversial.…”

Section: Introductionmentioning

confidence: 99%

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Gennaro

Stallone

Olivotto

et al. 2020

Preprint

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Background: The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods:We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis.Results: Thirty-four Children (47 feet) in the nonoperative group and twenty-one children (34 feet) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9-17): 11.6 (9-17) for the nonoperative group, 12.2 (10-15) for the operative group. The mean follow-up averaged 6.6 (3-12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years; p < 0.0005), since the operative procedure was increasingly practiced in the latest years.There were no complications in either groups, but 6 patients (7 feet) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusion:The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition. BackgroundThe congenital tarsal coalition is a partial or complete fusion between two or more midfoot or hindfoot bones, due to abnormal formation of bone, cartilage or fibrous tissue. (1) The incidence of tarsal coalition is about 1%, although, being often asymptomatic, the true

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“…FFF is a widespread idiopathic condition among children. In contrast with RFF, FFF is clinically characterised by the possibility of restoring a medial arch at physical examination when standing on tip toes or with the Jack's test (rise of the medial arch with great toe passive dorsiflexion) (10,11).Compared to FFF, RFF is most frequently symptomatic (12). Pain is present in about 25% of cases; symptoms generally start in the second decade of life, when the coalition ossifies.…”

Section: Introductionmentioning

confidence: 99%

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Gennaro

Stallone

Olivotto

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods: We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis. Results: Thirty-four Children (47 feet) in the nonoperative group and twenty-one children (34 feet) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9-17): 11.6 (9-17) for the nonoperative group, 12.2 (10-15) for the operative group. The mean follow-up averaged 6.6 (3-12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years; p < 0.0005), since the operative procedure was increasingly practiced in the latest years. There were no complications in either groups, but 6 patients (7 feet) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusions: The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition.

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The role of arthroereisis of the subtalar joint for flatfoot in children and adults

Cited by 69 publications

References 74 publications

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

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

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

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