Imaging findings of arthroereisis in planovalgus feet

Abstract

Arthroereisis is a rare and disputed procedure, where an implant screw is inserted into the sinus tarsi to treat flatfoot deformity. Weight-bearing radiographs are the most essential examinations to assess the correct localization and related measurements. Hardware loosening is the most common complication seen as localized lucency and as dislocation of the implant. Computed tomography yields superior resolution with reconstruction capabilities. On magnetic resonance imaging, the implant appears as a dark signal focus on T1 and T2-weighted images with a hyperintense T2-signal rim. As the data on the imaging of arthroereisis are scarce, we aimed here to review the typical imaging findings.

Postoperative Findings of Common Foot and Ankle Surgeries: An Imaging Review

“…Patients with flexible flatfoot deformity (hindfoot valgus, talar plantar flexion, and longitudinal arch collapse) who fail conservative management may benefit from surgical intervention [41]. Arthroereisis is a surgical procedure where a bioabsorbable or titanium implant is inserted into the sinus tarsi, expanding the subtalar joint and biomechanically restricting flatfoot deformity [42][43][44]. The name is derived from the Greek root -ereisis, translated as the action of supporting or lifting up.…”

“…Complications such as implant loosening, dislocation, lateral extrusion, and overcorrection of the deformity may be appreciated radiographically (Figure 11) [43]. Subtle implant migration, fractures, and peri-hardware lucency may be better evaluated with CT, whereas MRI may demonstrate postoperative soft-tissue abnormalities or bone-marrow edema [43]. Patients may complain of postoperative pain from sinus tarsi syndrome or accelerated subtalar osteoarthritis, which may be severe enough to require implant removal (Figure 12) [45].…”

“…Patients may complain of postoperative pain from sinus tarsi syndrome or accelerated subtalar osteoarthritis, which may be severe enough to require implant removal (Figure 12) [45]. Complications such as implant loosening, dislocation, lateral extrusion, and overcorrection of the deformity may be appreciated radiographically (Figure 11) [43]. Subtle implant migration, fractures, and peri-hardware lucency may be better evaluated with CT, whereas MRI may demonstrate postoperative soft-tissue abnormalities or bone-marrow edema [43].…”