Biomechanical assessment of two types and two different locations of subtalar arthroereisis implants for flexible flatfoot: A cadaveric study

2021 ◽  
Vol 89 ◽  
pp. 105475
Author(s):  
Sen Wang ◽  
Jian Yu ◽  
Maimaitirexiati Helili ◽  
Chao Zhang ◽  
Jiazhang Huang ◽  
...  
Keyword(s):  
Cadaveric Study ◽  
Biomechanical Assessment ◽  
Flexible Flatfoot ◽  
Subtalar Arthroereisis

scholarly journals Preliminary Results of Subtalar Arthroereisis with Vulpius Procedure for Symptomatic Flatfoot in Patients with Type I Osteogenesis Imperfecta

2020 ◽  
Vol 18 (1) ◽  
pp. 67
Author(s):  
Cheng-Min Hsu ◽  
Sheng-Chieh Lin ◽  
Kuan-Wen Wu ◽  
Ting-Ming Wang ◽  
Jia-Feng Chang ◽  
...  
Keyword(s):  
Osteogenesis Imperfecta ◽  
Weight Bearing ◽  
Life Quality ◽  
Type I ◽  
Foot And Ankle ◽  
Flexible Flatfoot ◽  
Subtalar Arthroereisis ◽  
Viable Approach ◽  
American Orthopaedic

In this retrospective study, we aim to assess the safety and feasibility of adapting subtalar arthroereisis (SA) for type I osteogenesis imperfecta (OI) patients with symptomatic flatfoot. From December 2013 to January 2018, six type I OI patients (five girls and one boy, 12 feet) with symptomatic flexible flatfoot were treated with SA and the Vulpius procedure. All the patients were ambulatory and skeletally immature with failed conservative treatment and unsatisfactory life quality. The median age at the time of surgery was 10 years (range 5–11), and the median follow-up period was 55 months (range 33–83). All functional and radiographic parameters improved (p < 0.05) after the procedure at the latest follow-up. The median American Orthopaedic Foot and Ankle Society ankle-hindfoot scale improved from 68 (range 38–80) to 95 (range 71–97). All of the patients ambulated well without significant complications. The weight-bearing radiographs showed maintained correction of the tarsal bone alignment with intact bony surfaces adjacent to implants during the post-operative follow-up period. This is the very first study on symptomatic flatfoot in pediatric patients with type I OI. Our data suggest that SA is a potentially viable approach, as functional improvements and maintained radiographic correction without significant complication were observed.

scholarly journals Body Weight Effects on Extra-Osseous Subtalar Arthroereisis

2019 ◽  
Vol 8 (9) ◽  
pp. 1273 ◽  
Author(s):  
Chiun-Hua Hsieh ◽  
Chia-Che Lee ◽  
Tzu-Hao Tseng ◽  
Kuan-Wen Wu ◽  
Jia-Feng Chang ◽  
...  
Keyword(s):  
Body Weight ◽  
Lateral View ◽  
The Body ◽  
Posterior View ◽  
Flexible Flatfoot ◽  
Subtalar Arthroereisis ◽  
Overweight Group ◽  
Anterior Posterior

Implant extrusion in subtalar arthroereisis is a common complication for pediatric flexible flatfoot. However, there were a limited number of articles addressing the body weight effects on implant extrusion after the procedure. We conducted a 24-month follow-up assessment after subtalar arthroereisis. Surgical patients who underwent the Vulpius procedure were retrospectively collected from May 2010 to January 2017, including 59 cases of both feet having implants in situ and 43 cases of both feet having implant extrusion. The average age of 102 patients was 9 years old. The mean body mass index (BMI) of the implant in situ group was 19.5, whilst the extrusion group was 21.2 (p = 0.035). The inter-observer correlation was excellent. There were 11 cases (39.3%) of bilateral extrusion in the overweight group (BMI ≥ 24) and 13 cases (23.2%) in the low body weight group (BMI ≤ 18.5) (p < 0.0004). Postoperative radiographic angles were corrected in both the implant in situ group and the extrusion group. Nonetheless, the implant in situ group revealed better postoperative outcomes of Meary’s angle and the talonavicular angle from an anterior-posterior view, and the talar inclination angle from a lateral view. We conclude that a higher BMI is related to implant extrusion and worse results after subtalar arthroereisis. Further prospective study to investigate whether preoperative weight loss results in improved surgical outcomes is warranted in the future.

Biomechanical assessment of a novel bone lengthening plate system — A cadaveric study

2013 ◽  
Vol 28 (2) ◽  
pp. 232-238 ◽  
Author(s):  
Tae Gon Jung ◽  
Seung Woo Suh ◽  
Sung Jae Lee ◽  
Bongju Kim ◽  
Dong-Wook Han ◽  
...  
Keyword(s):  
Cadaveric Study ◽  
Bone Lengthening ◽  
Biomechanical Assessment ◽  
System A ◽  
Plate System

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

2019 ◽  
pp. 193864001989206 ◽  
Author(s):  
Robin T. A. L. de Bot ◽  
Jasper Stevens ◽  
Joris P. S. Hermus ◽  
Heleen M. Staal ◽  
Lodewijk W. van Rhijn ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Functional Outcome ◽  
Revision Surgery ◽  
Clinical Symptoms ◽  
Case Series ◽  
Postoperative Phase ◽  
Levels Of Evidence ◽  
Flexible Flatfoot ◽  
Subtalar Arthroereisis

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

scholarly journals Subtalar Arthroereisis for Flexible Flatfoot in Children—Clinical, Radiographic and Pedobarographic Outcome Comparing Three Different Methods

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 359
Author(s):  
Bjoern Vogt ◽  
Gregor Toporowski ◽  
Georg Gosheger ◽  
Jan Duedal Rölfing ◽  
Dieter Rosenbaum ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
Group 4 ◽  
Sinus Tarsi ◽  
Flexible Flatfoot ◽  
Age At Surgery ◽  
Subtalar Arthroereisis ◽  
Foot Function ◽  
The Mean ◽  
Arch Index

Subtalar arthroereises (STA) is a minimally invasive and reversible surgery to correct symptomatic flexible flatfoot (FFF) in children. Various techniques were described either applying expandable sinus tarsi implants or lateral calcaneus stop screws. Studies comparing the outcome of STA with different devices are rare. This retrospective single-center cohort study analyzes the results of STA using three different implants. 113 STA were performed in 73 consecutive patients (28 females). Mean age at surgery was 10.8 years (range 5–16). Mean follow-up was 29.0 months (range 1–111). In 21 feet the non-absorbable Kalix® endorthesis and in 56 feet the absorbable Giannini endorthesis were applied. Subtalar extraarticular screw arthroereises (SESA) was conducted in 36 feet. Clinical, radiographic and pedobarographic parameters were analyzed. No intraoperative complications were observed. All three procedures achieved comparable improvements of the clinical, radiographic and pedobarographic parameters. The mean foot function index (FFI) improved from 36.4 (range 12–63) to 22.8 (range 2–55). The mean preoperative calcaneal inclination angle and the lateral talocalcaneal angle improved from 9.5° (range 0–22) and 42.3° (range 21–62) to 12.8° (range 0–26) and 37.6° (range 15–56), respectively. Pedobarographically determined values of the arch index, the medial midfoot contact area and the medial forefoot peak pressure decreased. In contrast to SESA (1/36, 3%), a higher incidence of implant-related complications was observed using Kalix® (6/21, 29%) and Giannini (10/56, 8%) sinus tarsi implants. Peroneal muscle contractures only occurred in the SESA group (4/36, 11%). Premature removal due to treatment-related complications was necessary in 6/21 Kalix® implants (29%), 4/56 Giannini implants (7%) and 4/36 SESA implants (11%). Implant choice for treatment of painful FFF in children with STA seems to play a subordinate role. Clinical, radiographic and pedobarographic outcomes are comparable between the applied implants. Surgeons and patients should be aware of the different spectrum of implant-related complications. Treatment can be reliably monitored by radiation-free pedobarography providing dynamic information about the deformity.

scholarly journals Subtalar Arthroereisis as an Adjunct Procedure Improves Forefoot Abduction in Stage IIb Adult- Acquired Flatfoot Deformity

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0013
Author(s):  
Alessio Bernasconi ◽  
Miltiadis Argyropoulos ◽  
Shelain Patel ◽  
Yaser Ghani ◽  
Nicholas Cullen ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Intraobserver Reliability ◽  
Related Complication ◽  
Spring Ligament ◽  
Metatarsal Angle ◽  
Flexible Flatfoot ◽  
Multivariable Regression Model ◽  
Subtalar Arthroereisis ◽  
Multivariable Regression ◽  
Flexor Digitorum

Category: Hindfoot; Midfoot/Forefoot Introduction/Purpose: Our aims were: (i) to determine whether subtalar arthroereisis (STA) as adjunct procedure improved radiographic correction of stage IIb adult acquired flexible flatfoot deformity (AAFD); (ii) to assess the STA-related complication rate. Methods: A retrospective analysis of 22 feet (21 patients) diagnosed with stage IIb AAFD treated by medialising calcaneal osteotomy (MCO), flexor digitorum longus (FDL) transfer, spring ligament (SL) repair with or without Cotton osteotomy and with or without STA in a single institution was carried out. Seven measurements were recorded on pre and postoperative (minimum 24 weeks) radiographs by two observers and repeated twice by one. Inter and intraobserver reliability was assessed. The association of demographic (gender, side, age, BMI) and surgical variables (Cotton, STA) with radiographic change was tested with univariate analysis followed by a multivariable regression model. Results: Excellent inter and intraobserver reliability was demonstrated for all measurements (ICC range, 0.75-0.99). Multivariable regression showed that STA was the only predictor of change in talo-navicular coverage angle (TNCA) (R2=0.31; p=0.03) and in calcaneo-fifth metatarsal angle (CFMA) (R2=0.40; p=0.02) on dorsoplantar view. STA was associated to a greater change in TNCA by 10.1 degrees and in CFMA by 5 degrees. Four patients out of 12 STA complained of sinus tarsi pain after STA, and removal of the implant resolved symptoms in 3 of them. Conclusion: In this series, STA as an adjunct procedure to MCO, FDL transfer, SL repair in the treatment of stage IIb AAFD led to improvement in correction of forefoot abduction. STA-related complication and removal rates were 33%.

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