Short- to Mid-Term Outcomes Following the Use of an Arthroereisis Implant as an Adjunct for Correction of Flexible, Acquired Flatfoot Deformity in Adults

• Published in: Foot and ankle specialist 2019-04, Vol.12 (2), p.122-130
• Main Authors: Walley, Kempland C., Greene, Gearin, Hallam, Jesse, Juliano, Paul J., Aynardi, Michael C.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Bone Screws; Case-Control Studies; Female; Flatfoot - diagnostic imaging; Flatfoot - etiology; Flatfoot - surgery; Follow-Up Studies; Foot Deformities, Acquired - diagnostic imaging; Foot Deformities, Acquired - etiology; Foot Deformities, Acquired - surgery; Humans; Male; Orthopedic Procedures - methods; Posterior Tibial Tendon Dysfunction - complications; Prosthesis Implantation; Radiography; Retrospective Studies; Time Factors; Treatment Outcome
• ISSN: 1938-6400; 1938-7636
• DOI: 10.1177/1938640018770242

Background. The use of an arthroereisis implant for the treatment of adolescent flatfoot deformity has been described. However, data that address the outcomes of patients treated with an arthroereisis implant in adults are limited. The purpose of this study was to investigate the radiographic and clinical outcomes and complications following the use of a subtalar arthroereisis implant as an adjunct for correction acquired flatfoot deformity secondary to posterior tibial tendon dysfunction. Methods. A retrospective case-control study was performed querying all patients undergoing surgical flatfoot correction between January 1, 2010 and January 1, 2015. The experimental group included patients undergoing arthroereisis augmentation at the time of flatfoot correction. Patients undergoing the same flatfoot correction without the use of an arthroereisis implant were used as controls. Radiographic measurements were evaluated preoperatively and at final radiographic follow-up and included talonavicular (TN) coverage angle, and lateral talar–first metatarsal angle (T1MA). Patient-reported outcomes were assessed using preoperative visual analog scale (VAS) pain scores and postoperative Short Form–36, VAS, and satisfaction at final orthopedic follow-up. Results. A total of 15 patients underwent flatfoot correction and were augmented with an arthroereisis implant and were matched with 30 controls. Postoperative, mid-term T1MA and regional analysis was found to be improved in the experimental group versus control. Patients undergoing adjunct subtalar arthroereisis demonstrated an increased likelihood of achieving radiographically normal talonavicular coverage