Triple Arthrodesis for Adult Acquired Flatfoot

Catanzariti, Alan R.; Dix, Brian T.; Richardson, Phillip E.; Mendicino, Robert W.

doi:10.1016/j.cpm.2014.03.004

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…However, we agree with the literature reviewed [13–15] that it is important to consider the necessity of adjunct procedures such as gastrocnemius recession or medial displacement osteotomy of the calcaneus in persistent ankle valgus. A medial column stabilization could also be considered either in the form of naviculocuneiform arthrodesis or first tarsometatarsal arthrodesis.…”

Section: Discussionsupporting

confidence: 89%

“…In the more severe flatfoot the triple arthrodesis has traditionally been the procedure of choice [13–15]. It has proven to be a predictable procedure with universally good results and high patient satisfaction [13].…”

Section: Discussionmentioning

confidence: 99%

“…It has proven to be a predictable procedure with universally good results and high patient satisfaction [13]. Nonetheless, complications have been reported such as degeneration of surrounding joints, inadequate realignment in cases with severe transverse plane deformity, increased risk of forefoot varus deformity, and lateral wound problems.…”

Section: Discussionmentioning

confidence: 99%

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A mid-term follow-up of Koutsogiannis’ osteotomy in adult-acquired flatfoot stage II and “early stage III”

Arvinius

Manrique

Urda

et al. 2017

SICOT-J

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Introduction: Koutsogiannis’ osteotomy has been widely described to treat adult-acquired flatfoot. However, few articles describe its midterm follow-up. Our aim was to study clinical and radiological outcomes at least one year after surgery and to analyze whether a combined procedure on the medial soft tissue affected these outcomes. Methods: We performed a retrospective study of 30 feet of patients who underwent a Koutsogiannis’ osteotomy due to adult-acquired flatfoot stage II and “early stage III”: a stage III acquired flatfoot without any important structural deformities. The parameters studied were additional medial soft tissue procedures, clinical outcome through the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and midfoot score as well as complications and radiological measurements. Results: Sixteen cases were “early stage III” and 14 stage II. Thirteen patients underwent an associated posterior tibial tendon (PTT) revision: in three cases an end-to-end suture was possible, seven cases needed a FDL transposition, and three underwent synovectomy. Statistically significant improvement was found in the AOFAS score although no significant changes were seen radiologically. No additional benefit was found with the revision of the posterior tibial tendon. As to clinical and radiological results, no differences were found between stage II and “early stage III”. Five cases presented a mild dysesthesia but only one patient needed neurolysis. Conclusions: We consider the Koutsogiannis’ osteotomy to be a safe and effective procedure to reduce pain in patients with stage II and “early stage III” adult-acquired flatfoot.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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A mid-term follow-up of Koutsogiannis’ osteotomy in adult-acquired flatfoot stage II and “early stage III”

Arvinius

Manrique

Urda

et al. 2017

SICOT-J

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“…Similarly, arthrodesis of the hindfoot (3)(4)(5)(6), midfoot (7,8), tarsometatarsal (9), and metatarsophalangeal (10) and triple arthrodesis of the talocalcaneal, talonavicular, and calcaneocuboid joints (11) can treat functional impairment and deformity secondary to Charcot arthropathy, trauma, degenerative joint disease, and rheumatoid arthritis (12). A variety of surgical techniques exist for achieving fusion of the joints in the foot and ankle, ranging from external fixator-assisted arthrodesis (13)(14)(15) to open arthrodesis (1,(16)(17)(18)(19)(20)(21)(22)(23) and arthroscopically assisted arthrodesis (24,25).…”

mentioning

confidence: 98%

National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey

Buller

Miranda

2015

The Journal of Foot and Ankle Surgery

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“…Treatment options for rigid AAFD include double or triple arthrodesis, lateral column lengthening at the calcaneocuboid joint, and even arthrodesis of singular hindfoot joints such as the talonavicular, subtalar, or calcaneocuboid articulation. 16-22…”

mentioning

confidence: 99%

Fusion Versus Joint-Sparing Reconstruction for Patients With Flexible Flatfoot

Whitelaw

Shah

Hagemeijer

et al. 2020

Foot & Ankle Specialist

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Aims Passively correctible, adult-acquired flatfoot deformities (AAFD) are treated with joint-sparing procedures. Questions remain as to the efficacy of such procedures when clinical deformities are severe. In severe deformities, a primary fusion may lead to predictable outcomes, but risks nonunion. We evaluated pre- and postsurgical flexible AAFD patients undergoing joint-sparing or fusion procedures, comparing reoperation and complication rates. Methods We identified patients with flexible AAFD between January 1, 2001 and 2016. Exclusion criteria were incomplete medical record, rigid AAFD, and prior flatfoot surgery. Patient demographics, pre- and postsurgical radiographic measurements, surgery performed, and postoperative complications were evaluated by bivariate analysis, comparing joint-sparing versus fusion procedures. Results Of 239 patients (255 feet) (mean follow-up 62 ± 50 months), 209 (87%) underwent joint-sparing reconstructions, 30 (12.6%) underwent fusions. Fifty-four (24.1%) feet underwent joint-sparing reconstruction with reoperation versus 11 (35.5%) in fusion patients ( P = .17). Radiographic improvement in talonavicular angle, talar first-metatarsal (anteroposterior view), and Meary’s angle was higher in fusion patients ( P < .001, P < .001, and P = .003, respectively). Discussion More nonunion reoperations among fusion patients were offset by reoperations in joint-sparing patients. Fusion uniquely corrected Meary’s angle. Nonunion is of less concern for joint-sparing versus fusion for patients with severe flexible AAFD. Degree of deformity versus advantage of joint motion should improve decision making. Levels of Evidence: Level IV: Retrospective case series

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Triple Arthrodesis for Adult Acquired Flatfoot

Cited by 10 publications

References 8 publications

A mid-term follow-up of Koutsogiannis’ osteotomy in adult-acquired flatfoot stage II and “early stage III”

A mid-term follow-up of Koutsogiannis’ osteotomy in adult-acquired flatfoot stage II and “early stage III”

National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey

Fusion Versus Joint-Sparing Reconstruction for Patients With Flexible Flatfoot

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