Clinical outcomes of subtalar arthroereisis for the treatment of stage 1 flexible progressive collapsing foot deformity
Lewis, Thomas L Goff, Thomas A J Ray, Robbie Dhaliwal, Jagwinder Carmody, David Wines, Andrew P
Lewis, Thomas L
Goff, Thomas A J
Ray, Robbie
Dhaliwal, Jagwinder
Carmody, David
Wines, Andrew P
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Affiliation
King's College Hospital NHS Foundation Trust; Mid Yorkshire Hospitals NHS Trust; Sandwell and West Birmingham NHS Trust; North Sydney Orthopaedic and Sports Medicine Centre
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Publication date
2024-05-30
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Abstract
Background: The use of subtalar arthroereisis as an adjunct to the surgical treatment of stage 1 flexible progressive collapsing foot deformity (PCFD) is controversial. The aim was to investigate the clinical outcomes and report the implant removal rate of subtalar arthroereisis as an adjunct for stage 1 PCFD. Methods: A retrospective study of 212 consecutive feet undergoing operative management of stage 1 PCFD with adjunctive subtalar arthroereisis between October 2010 and April 2018. The primary outcome was the Foot and Ankle Outcome Score (FAOS). Secondary outcomes included Foot and Ankle Disability Index (FADI), Euroqol-5D-5L Index and implant removal rate. Results: Post-operative clinical FAOS outcomes were collected for 153 feet (72.2%). At mean 2.5-year follow-up, the mean ± standard deviation FAOS for each domain was as follows; Pain: 81.5 ± 18.5, Symptoms: 79.5 ± 12.9, Activities of Daily Living: 82.5 ± 15.4 and Quality of Life: 64.2 ± 23.7. EQ-5D-5L Index was 0.884 ± 0.152. Pre-operative scores were available for 20 of these feet demonstrating a statistically significant improvement in all FAOS, FADI and EQ-5D-5L domains (p < 0.05). The implant removal rate for persistent sinus tarsi pain was 48.1% (n = 102). Conclusion: Use of a subtalar arthroereisis implant as an adjunct to conventional procedures in stage 1 flexible PCFD can result in significant improvement in pain and function. Patients should be counselled as to the relatively frequent rate of subsequent implant removal.
Citation
Lewis TL, Goff TAJ, Ray R, Dhaliwal J, Carmody D, Wines AP. Clinical outcomes of subtalar arthroereisis for the treatment of stage 1 flexible progressive collapsing foot deformity. Eur J Orthop Surg Traumatol. 2024 May 30. doi: 10.1007/s00590-024-04007-4
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Article