Double Arthrodesis Through a Medial Approach for End-Stage Adult-Acquired Flatfoot

Catanzariti, Alan R.; Adeleke, Adebola T

doi:10.1016/j.cpm.2014.04.001

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…In the authors' view, this difference confirms both procedures presented in the study as adequate treatments. However, the authors' experience is consistent with the prevailing opinion in the literature that talonavicular arthrodesis is the standard of surgical treatment for AAFD [27][28][29][30]. Therefore, radiological results should not be considered in isolation from the clinical outcome.…”

Section: Discussionsupporting

confidence: 84%

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

Fischer

Oepping

Altmeppen

et al. 2022

JCM

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Background: Adult-acquired flatfoot deformity due to posterior tibial tendon dysfunction (PTTD) is one of the most common foot deformities among adults. Hypothesis: Our study aimed to confirm that the combined procedures of calcaneal displacement osteotomy and talonavicular arthrodesis are equivalent to double arthrodesis. Methods: Between 2016 and 2020, 41 patients (13 male and 28 females, mean age of 63 years) were retrospectively enrolled in the comparative study. All deformities were classified into Stages II and III of PTTD, according to Johnson and Strom. All patients underwent isolated bony realignment of the deformity: group A (n = 19) underwent calcaneal displacement osteotomy and talonavicular arthrodesis, and group B (n = 23) underwent double arthrodesis. Measurements from the Foot Function Index-D (FFI-D) and the SF-12 questionnaire were collected, with a comparison of pre- and post-operative radiographs conducted. The mean follow-up period for patients was 3.4 years. Results: The mean FFI-D was 33.9 (group A: 34.5; group B: 33.5), the mean SF-12 physical component summary was 43.13 (group A: 40.9; group B: 44.9), and the mean SF-12 mental component summary was 43.13 (group A: 40.9; group B: 44.9). The clinical data and corrected angles showed no significant intergroup differences. Conclusion: Based on the available data, our study confirmed that the combined procedures of talonavicular arthrodesis and calcaneal shift, with preservation of the subtalar joint, can be considered equivalent to the established double arthrodesis, with no significant differences in terms of clinical and radiological outcomes.

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Section: Discussionsupporting

confidence: 84%

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

Fischer

Oepping

Altmeppen

et al. 2022

JCM

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“…2,4,[17][18][19][20] Furthermore, placing the incision medially has been shown to improve visualization and exposure of the transverse tarsal joint 3,4,20 and to allow good control of the position of the joints to be fused. 3,4,17,20,21 The improved visualization facilitates debridement of the joints without placing the posteromedial structures, especially the flexor hallucis longus tendon, at risk. 4,17 As an alternative to the triple arthrodesis, the ST joint can be fused in combination with the naviculocuneiform joint.…”

Section: Tibialis Posterior Tendon Dysfunctionmentioning

confidence: 98%

Medial Approach to the Subtalar Joint

Knupp¹,

Zwicky²,

Lang³

et al. 2015

Foot and Ankle Clinics

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“…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. Some authors [14] refer that they prefer double arthrodesis when a severe subluxation of the TNJ is found on the AP radiograph. We found no clinical nor radiological significant differences between stage II and “early stage III”.…”

Section: Discussionmentioning

confidence: 99%

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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Double Arthrodesis Through a Medial Approach for End-Stage Adult-Acquired Flatfoot

Cited by 11 publications

References 22 publications

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

Adult-Acquired Flatfoot Deformity: Combined Talonavicular Arthrodesis and Calcaneal Displacement Osteotomy versus Double Arthrodesis

Medial Approach to the Subtalar Joint

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

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