The outcomes of subtalar arthroereisis in pes planus: a systemic review and meta-analysis

Tan, Joelle Hwee Inn; Tan, Si Heng Sharon; Lim, Andrew Kean Seng; Hui, James

doi:10.1007/s00402-020-03458-8

Cited by 22 publications

(41 citation statements)

References 30 publications

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“…Their review could be criticized for including patients aged up to 21 years and also studies treating rigid pes planus. 49 Patient age at time of surgery appears to play an important factor, with 9 to 12 years thought to be optimal. Younger patients are at higher risk of recurrence and older patients have less successful outcomes, likely due to the reduced ability of the foot to remodel.…”

Section: Discussionmentioning

confidence: 99%

Subtalar arthroereisis for the treatment of the symptomatic paediatric flexible pes planus: a systematic review

et al. 2021

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Subtalar arthroereisis has a controversial history and has previously been associated with high failure rates and excessive complications. A database search for outcomes of arthroereisis for the treatment of symptomatic paediatric flexible pes planus provided 24 articles which were included in this review, with a total of 2550 feet operated on. Post-operative patient-reported outcome measures recorded marked improvement. Patient satisfaction was reported as excellent in 79.9%, and poor in 5.3%. All radiological measurements demonstrated improvement towards the normal range following arthroereisis, as did hindfoot valgus, supination, dorsiflexion and Viladot grade. Complications were reported in 7.1% of cases, with a reoperation rate of 3.1%. Arthroereisis as a treatment for symptomatic paediatric flexible pes planus produces favourable outcomes and high patient satisfaction rates with a reasonable risk profile. There is still a great deal of negativity and literature highlighting the complications and failures of arthroereisis, especially for older implants. The biggest flaws in the collective literature are the lack of high-quality prospective studies, a paucity of long-term data and the heterogeneity of utilized outcome measures between studies. Cite this article: EFORT Open Rev 2021;6:118-129. DOI: 10.1302/2058-5241.6.200076

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Section: Discussionmentioning

confidence: 99%

Subtalar arthroereisis for the treatment of the symptomatic paediatric flexible pes planus: a systematic review

et al. 2021

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“…In this review, the overall complication rate was 8.2%; 7.2% with CS devices and 9.7% with subtalar AR. Differences in the potential for complications are related to the CS technique or subtalar self-locking devices[ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Arthroereisis in juvenile flexible flatfoot: Which device should we implant? A systematic review of literature published in the last 5 years

Vescio

Testa

Amico

et al. 2021

WJO

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BACKGROUND Flexible flatfoot (FFF) is a very common condition in children, characterized by the loss of the medial arch and by an increase in the support base with valgus of the hindfoot. Arthroereisis (AR) procedures are widely performed corrective surgeries and are classified as subtalar AR and calcaneo-stop (CS). AIM We investigated the literature published in the last 5 years with the aim of providing an update on the evidence related to AR treatment in FFF patients. We report the principal findings of subtalar AR and CS procedures concerning clinical and radiological outcomes and complication rates in the general population, young athletes, and obese people according to material device. METHODS Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic review of studies published in the past 5 years and included the PubMed and Science Direct databases was performed on May 6, 2020. The research string used was (pediatric OR children OR Juvenile NOT adult) AND (flexible NOT rigid) AND (flat foot OR pes planus) AND (calcaneo-Stop OR arthroereisis OR subtalar extra-articular screw OR SESA OR subtalar arthroereisis OR endosinotarsal). The risk of bias assessment was performed using the Dutch checklist form for prognosis. RESULTS A total of 47 articles were found. Ultimately, after reading the full text and checking reference lists, we selected 17 articles that met the inclusion and exclusion criteria. A total of 1864 FFFs were identified. Eight studies concerned the subtalar AR (47.1%) and nine concerning CS (52.9%). The average age of patients at start of treatment was 11.8 years, the average follow-up of the studies was 71.9 mo (range 29.1-130). Globally, complications occurred in 153 of the 1864 FFF treated, with a rate of 8.2%. CONCLUSION Both AR procedures are valid surgical techniques for treating FFF. Surgeon experience, implant cost, and cosmetic correction are the most common considerations included in the orthopedic device decision-making process. In obese patients, the subtalar AR is not recommended. In adolescents who need to improve sports performance, the CS screw had better results compared with other implants.

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“…The procedure corrects the alignment of flatfoot, especially on lateral tarso-metatarsal alignment and talo-navicular congruency, and maintains this correction in the short to the mid-term until skeletal maturity [ 7 , 8 ]. Previous systematic reviews [ 9 , 10 , 11 ] of SA showed less tissue trauma and faster recovery with comparable results in correcting flatfeet to other managements in general populations. Characterized by a non-fusion nature and less tissue injury, SA may benefit OI patients in dealing with flatfoot.…”

Section: Introductionmentioning

confidence: 80%

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

Hsu

Lin

et al. 2020

IJERPH

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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.

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The outcomes of subtalar arthroereisis in pes planus: a systemic review and meta-analysis

Cited by 22 publications

References 30 publications

Subtalar arthroereisis for the treatment of the symptomatic paediatric flexible pes planus: a systematic review

Subtalar arthroereisis for the treatment of the symptomatic paediatric flexible pes planus: a systematic review

Arthroereisis in juvenile flexible flatfoot: Which device should we implant? A systematic review of literature published in the last 5 years

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

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