Factors Predictive of Second Recurrence in Clubfeet Treated by Ponseti Casting

Luckett, Matthew R.; Hosseinzadeh, Pooya; Ashley, Philip; Muchow, Ryan D.; Talwalkar, Vishwas; Iwinski, Henry J.; Walker, Janet L.; Milbrandt, Todd A.

doi:10.1097/bpo.0000000000000248

Cited by 27 publications

(27 citation statements)

References 14 publications

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“…These findings are further supported by other recent studies that demonstrate TATT improves pressure distribution through the foot during gait [39] and restores foot eversion strength [40]. While the data demonstrate TATT is a highly effective tool for preventing relapse of clubfoot, new literature suggests that a second recurrence after TATT can occur in as many as 20 % of patients [41]. Luckett et al found that young age at the time of TATT and poor brace compliance were predictive of a second recurrence and recommended that these cases be monitored closely.…”

Section: Tibialis Anterior Tendon Transfersupporting

confidence: 75%

What is new in idiopathic clubfoot?

O'Shea¹,

Sabatini

2016

Curr Rev Musculoskelet Med

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Section: Tibialis Anterior Tendon Transfersupporting

confidence: 75%

What is new in idiopathic clubfoot?

O'Shea¹,

Sabatini

2016

Curr Rev Musculoskelet Med

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“…It is clear from our results that with longer follow-up, patients are likely to require additional surgical procedures to maintain the correction. Compliance with the Ponseti protocol and the use of orthotics are also crucial to reduce the risk of relapse as has been reported extensively in the literature [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Treatment of complex idiopathic clubfoot using the modified Ponseti method: up to 11 years follow-up

Matar

Beirne

Bruce

et al. 2017

Journal of Pediatric Orthopaedics B

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“… 1 However, subsequent treatment to maintain correction of the deformity with prolonged bracing can be difficult at times, 2 and recurrence rates requiring further procedures are 20% to 40% even in the best of hands. 1 , 3 - 7 …”

Section: Purposementioning

confidence: 99%

Clubfoot relapse: Does presentation differ based on age at initial relapse?

Mahan

Spencer

May

et al. 2017

Journal of Children's Orthopaedics

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PurposeTreatment of idiopathic clubfoot with the Ponseti method is now standard, but predicting relapse can be difficult. Most experts recommend bracing to the age of four years, but this can be challenging for families, and may not be necessary in all patients. The purpose of this study is to compare patterns of bracing and age of relapse to help determine if predictable patterns exist.MethodsThe 70 patients with idiopathic clubfoot treated initially with the Ponseti technique who had relapse of their clubfoot were identified. Relapse was defined as a return to casting or surgery due to recurrent deformity. Data collected included demographics, treatment and brace adherence. Patients who sustained initial relapse before the age of two years were compared with those who sustained initial relapse after the age of two years.ResultsIn total 56% (39/70) had their initial relapse prior to age two years while 44% (31/70) were after age two years. Of the patients who relapsed prior to the age of two years, 28% (11/39) were adherent with bracing while 72% were non-adherent. For patients who initially relapsed after age two, 74% (23/31) were adherent with bracing while 26% were non-adherent (p < 0.001). Of those who had initial relapse prior to age two, a subsequent relapse was seen in 69% (27/39).ConclusionPatients with idiopathic clubfoot who experienced recurrence prior to age two years are significantly more likely to be non-adherent with bracing than those who sustain recurrence after age two. After initial relapse prior to age two, bracing adherence does not affect likelihood of subsequent recurrence.

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Factors Predictive of Second Recurrence in Clubfeet Treated by Ponseti Casting

Abstract: Level II-prognostic.

Cited by 27 publications

References 14 publications

What is new in idiopathic clubfoot?

What is new in idiopathic clubfoot?

Treatment of complex idiopathic clubfoot using the modified Ponseti method: up to 11 years follow-up

Clubfoot relapse: Does presentation differ based on age at initial relapse?

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