Top

Published in:

01-04-2018 | Review

Bioabsorbable implants for subtalar arthroereisis in pediatric flatfoot

Authors: C. Faldini, A. Mazzotti, A. Panciera, F. Perna, N. Stefanini, S. Giannini

Published in: MUSCULOSKELETAL SURGERY | Issue 1/2018

Abstract

Flatfoot is a common condition in growing-age patients. Despite its common presentation, nowadays surgical indications and treatments are still debated. Arthroereisis is a widely used technique, and several implants designs have been proposed over time. Despite the good results shown in the literature, the main drawback of these techniques has always been the need for a second surgery for implant removal. Bioabsorbable devices have been introduced to overcome this necessity.Correct approach to the patient, indications and contraindications and available studies on bioabsorbable implants for subtalar arthroereisis in pediatric flatfoot were analyzed in this narrative review. Even if only a few studies have been published in the literature, bioabsorbable implants showed good clinical results comparable to non-absorbable implants and with a rare necessity for implant removal or revision. When correct indications and proper surgical technique are followed, arthroereisis with bioabsorbable implants appears to be an effective solution for the treatment of pediatric flexible flatfoot.

Coughlin MJ, Mann RA (2001) Chirurgia del Piede e della Caviglia. 7th edn. vol 1, Verduci Editore, Rome

Solomon L, Warwick D, Nayagam S (2010) Apley’s system of orthopaedics and fractures, 9th edn. Hodder Arnold, London, pp 596–600CrossRef

Kim M-K, Lee Y-S (2013) Kinematic analysis of the lower extremities of subjects with flat feet at different gait speeds. J Phys Ther Sci 25(5):531–533PubMedPubMedCentralCrossRef

Pourghasem M, Kamali N, Farsi M, Soltanpour N (2016) Prevalence of flatfoot among school students and its relationship with BMI. Acta Orthop Traumatol Turc 50(5):554–557PubMedCrossRef

Kothari A, Bhuva S, Stebbins J, Zavatsky AB, Theologis T (2016) An investigation into the aetiology of flexible flat feet. Bone Jt J 98–B(4):564–568CrossRef

Gould N, Moreland M, Trevino S, Alvarez R, Fenwick J, Bach N (1990) Foot growth in children age 1 to 5 years. Foot Ankle. 10(4):211–213PubMedCrossRef

Smith MA (1990) Flat feet in children. BMJ Br Med J. 301(6758):942CrossRef

Herring JA (2013) Tachdjian’s Pediatric Orthopaedics. 5th edn. Elsevier, Philadelphia

Faldini C, Nanni M, Traina F, Fabbri D, Borghi R, Giannini S (2016) Surgical treatment of hallux valgus associated with flexible flatfoot during growing age. Int Orthop 40(4):737–743PubMedCrossRef

10.

Benedetti MG, Ceccarelli F, Berti F, Luciani D, Catani F, Faldini C et al (2011) Diagnosis of flexible flatfoot in children: a systematic clinical approach. Orthopedics 34(2):94PubMed

11.

Giannini S, Ceccarelli F, Benedetti MG, Catani F, Faldini C (2001) Surgical treatment of flexible flatfoot in children. J Bone Jt Surg Am 83(2 suppl 2):S73–S79CrossRef

12.

Mosca VS (2010) Flexible flatfoot in children and adolescents. J Child Orthop 4(2):107PubMedPubMedCentralCrossRef

13.

Needleman RL (2005) Current topic review: subtalar arthroereisis for the correction of flexible flatfoot. Foot Ankle Int 26(4):336–346PubMedCrossRef

14.

Verheyden F, Vanlommel E, Van Der Bauwhede J, Fabry G, Molenaers G (1997) The sinus tarsi spacer in the operative treatment of flexible flat feet. Acta Orthop Belg 63(4):305–309PubMed

15.

Giannini S, Kenneth A, Johnson Memorial Lecture (1998) Operative treatment of the flatfoot: why and how. Foot Ankle Int 19(1):52–58PubMedCrossRef

16.

Marengo L, Canavese F, Mansour M, Dimeglio A, Bonnel F (2017) Clinical and radiological outcome of calcaneal lengthening osteotomy for flatfoot deformity in skeletally immature patients. Eur J Orthop Surg Traumatol 1–8. doi:10.1007/s00590-017-1909-9

17.

Yontar NS, Ogut T, Guven MF, Botanlioglu H, Kaynak G, Can A (2016) Surgical treatment results for flexible flatfoot in adolescents. Acta Orthop Traumatol Turc 50(6):655–659PubMedCrossRef

18.

Cashmere T, Smith R, Hunt A (1999) Medial longitudinal arch of the foot: stationary versus walking measures. Acta Orthop Traumatol Turc 20(2):112–118

19.

Lin Y-C, Kwon JY, Ghorbanhoseini M, Wu JS (2016) The Hindfoot Arch. Radiol Clin North Am 54(5):951–968PubMedCrossRef

20.

Peterson H (1986) Growing pains. Pediatr Clin North Am 33(6):1365–1372PubMedCrossRef

21.

Jerosch J, Schunck J, Abdel-Aziz H (2009) The stop screw technique—a simple and reliable method in treating flexible flatfoot in children. Foot Ankle Surg 15(4):174–178PubMedCrossRef

22.

Schon LC (2007) Subtalar arthroereisis: a new exploration of an old concept. Foot Ankle Clin 12(2):329–339PubMedCrossRef

23.

Kido M, Ikoma K, Hara Y, Imai K, Maki M, Ikeda T et al (2014) Effect of therapeutic insoles on the medial longitudinal arch in patients with flatfoot deformity: a three-dimensional loading computed tomography study. Clin Biomech (Bristol, Avon). NIH Public Access 29(10):1095–1098CrossRef

24.

Dare DM, Dodwell ER (2014) Pediatric flatfoot: cause, epidemiology, assessment, and treatment. Curr Opin Pediatr 26(1):93–100PubMedCrossRef

25.

Giannini S, Ceccarelli F (1998) The flexible flat foot. Foot Ankle Clin 3:573–592

26.

Kwon JY, Myerson MS (2010) Management of the flexible flat foot in the child: a focus on the use of osteotomies for correction. Foot Ankle Clin 15(2):309–322PubMedCrossRef

27.

Rose GK, Welton EA, Marshall T (1985) The diagnosis of flat foot in the child. J Bone Joint Surg Br 67(1):71–78PubMedCrossRef

28.

Giannini S, Catani F, Ceccarelli F, Girolami M, Benedetti MG (1992) Kinematic and isokinetic evaluation of patients with flat foot. Ital J Orthop Traumatol 18(2):241–251PubMed

29.

Bouchard M, Mosca VS (2014) Flatfoot deformity in children and adolescents: surgical indications and management. J Am Acad Orthop Surg 22(10):623–632PubMedCrossRef

30.

Singh D (2013) Nils Silfverskiöld (1888–1957) and gastrocnemius contracture. Foot Ankle Surg 19(2):135–138PubMedCrossRef

31.

Leardini A, Benedetti MG, Berti L, Bettinelli D, Nativo R, Giannini S (2007) Rear-foot, mid-foot and fore-foot motion during the stance phase of gait. Gait Posture 25(3):453–462PubMedCrossRef

32.

Lin Y-C, Mhuircheartaigh JN, Lamb J, Kung JW, Yablon CM, Wu JS (2015) Imaging of adult flatfoot: correlation of radiographic measurements with MRI. Am J Roentgenol 204(2):354–359CrossRef

33.

Kaschak TJ, Laine W (1988) Surgical radiology. Clin Podiatr Med Surg 5(4):797–829PubMed

34.

Moreau M, Costa-Bertani G (1943) Roentgen study of flat foot. Year B Radiol 81:82

35.

Benedetti MG, Berti L, Straudi S, Ceccarelli F, Giannini S (2010) Clinicoradiographic assessment of flexible flatfoot in children. J Am Podiatr Med Assoc 100(6):463–471PubMedCrossRef

36.

Sangeorzan BJ, Mosca V, Hansen ST (1993) Effect of calcaneal lengthening on relationships among the hindfoot, midfoot, and forefoot. Foot Ankle 14(3):136–141PubMedCrossRef

37.

Giannini S, Ceccarelli F, Vannini F, Baldi E (2003) Operative treatment of flatfoot with talocalcaneal coalition. Clin Orthop Relat Res 411:178–187CrossRef

38.

De Pellegrin M, Moharamzadeh D, Strobl WM, Biedermann R, Tschauner C, Wirth T (2014) Subtalar extra-articular screw arthroereisis (SESA) for the treatment of flexible flatfoot in children. J Child Orthop 8(6):479–487PubMedPubMedCentralCrossRef

39.

de Retana P, Álvarez F, Viladot R (2010) Subtalar arthroereisis in pediatric flatfoot reconstruction. Foot Ankle Clin 15(2):323–335CrossRef

40.

Dennyson WG, Fulford GE (1976) Subtalar arthrodesis by cancellous grafts and metallic internal fixation. Bone Jt J 58–B(4):507–510CrossRef

41.

Kelikian A, Mosca V, Schoenhaus HD, Winson I, Weil L (2011) When to operate on pediatric flatfoot. Foot Ankle Spec 4(2):112–119PubMedCrossRef

42.

Harris EJ, Vanore JV, Thomas JL, Kravitz SR, Mendelson SA, Mendicino RW et al (2004) Diagnosis and treatment of pediatric flatfoot. J Foot Ankle Surg 43(6):341–373PubMedCrossRef

43.

Kellermann P, Roth S, Gion K, Boda K, Tóth K (2011) Calcaneo-stop procedure for paediatric flexible flatfoot. Arch Orthop Trauma Surg 131(10):1363–1367PubMedCrossRef

44.

Roth S, Roth A, Jotanovic Z, Madarevic T (2013) Navicular index for differentiation of flatfoot from normal foot. Int Orthop 37(6):1107PubMedPubMedCentralCrossRef

45.

Shah NS, Needleman RL, Bokhari O, Buzas D (2015) 2013 subtalar arthroereisis survey: the current practice patterns of members of the AOFAS. Foot Ankle Spec 8(3):180–185PubMedCrossRef

46.

Usuelli FG, Montrasio UA (2012) The calcaneo-stop procedure. Foot Ankle Clin 17(2):183–194PubMedCrossRef

47.

Vulcano E, Maccario C, Myerson MS (2016) How to approach the pediatric flatfoot. World J Orthop 7(1):1PubMedPubMedCentralCrossRef

48.

Giannini S, Ceccarelli F, Girolami M, Vincenti G (1985) Il trattamento del piede piatto infantile con endortesi ad espansione, tecnica e valutazione dei primi 50 casi consecutivi. Chir del piede

49.

Giannini S, Faldini C, Luciani D, Cadossi M, Capra P, Persiani V et al. (2010) Piede piatto: endortesi riassorbibile. G Ital di Ortop e Traumatol. 36:278–284

50.

Metcalfe SA, Bowling FL, Reeves ND (2011) Subtalar joint arthroereisis in the management of pediatric flexible flatfoot: a critical review of the literature. Foot Ankle Int 32(12):1127–1139PubMedCrossRef

51.

Roth S, Sestan B, Tudor A, Ostojic Z, Sasso A, Durbesic A (2007) Minimally invasive calcaneo-stop method for idiopathic, flexible pes planovalgus in children. Foot Ankle Int 28(9):991–995PubMedCrossRef

52.

Pavone V, Costarella L, Testa G, Conte G, Riccioli M, Sessa G (2013) Calcaneo-stop procedure in the treatment of the juvenile symptomatic flatfoot. J Foot Ankle Surg 52(4):444–447PubMedCrossRef

53.

Zhai JN, Qiu YS, Wang J (2016) Effects of orthotic insoles on adults with flexible flatfoot under different walking conditions. J Phys Ther Sci 28(11):3078PubMedPubMedCentralCrossRef

54.

Sim-Fook L, Hodgson AR (1958) A comparison of foot forms among the non-shoe and shoe-wearing Chinese population. J Bone Jt Surg Am 40–A(5):1058–1062CrossRef

55.

Miller O (1927) A plastic flat foot operation. Am J Surg 2(3):286–287CrossRef

56.

Vulcano E, Maccario C, Myerson MS (2016) How to approach the pediatric flatfoot. World J Orthop. 7(1):1–7PubMedPubMedCentralCrossRef

57.

Baker JR, Klein EE, Weil L, Weil LS, Knight JM (2013) Retrospective analysis of the survivability of absorbable versus nonabsorbable subtalar joint arthroereisis implants. Foot Ankle Spec 6(1):36–44PubMedCrossRef

58.

Jay RM, Din N (2013) Correcting pediatric flatfoot with subtalar arthroereisis and gastrocnemius recession. Foot Ankle Spec 6:101–107. doi:10.1177/1938640012470714 PubMedCrossRef

59.

Ruozi B, Belletti D, Manfredini G, Tonelli M, Sena P, Vandelli MA et al (2013) Biodegradable device applied in flatfoot surgery: comparative studies between clinical and technological aspects of removed screws. Mater Sci Eng 33(3):1773–1782. doi:10.1016/j.msec.2012.12.093 CrossRef

60.

Giannini S, Cadossi M, Mazzotti A, Persiani V, Tedesco G, Romagnoli M et al (2017) Bioabsorbable calcaneo-stop implant for the treatment of flexible flatfoot: a retrospective cohort study at a minimum follow-up of 4 Years. J Foot Ankle Surg 56(4):776–782. doi:10.1053/j.jfas.2017.02.018 PubMedCrossRef

61.

Burutaran JM (1979) El calcaneo-stop para el tratamiento del valgo de talon infantil. Chir del piede 3:319–322

62.

Milano L, Scala A (1985) La risi extrarticolare della sottoastragalica con endortesi calcaneale nel trattamento chirurgico delle deformità in valgo del calcagno. Chir Piede. 9:303–322

63.

Castaman E (1985) L’intervento di calcaneo-stop nel piede piatto valgo. Chir Piede. 9:319–329

64.

Magnan B, Baldrighi C, Papadia D (1997) Flatfeet: comparison of surgical techniques. Result of study group into retrograde endorthesis with calcaneus-stop. Ital J Ped Orthop. 13:28–33

65.

Bauer K, Mosca VS, Zionts LE (2016) What’s new in pediatric flatfoot? J Pediatr Orthop 36(8):865–869. doi:10.1097/BPO.0000000000000582 PubMedCrossRef

66.

Giannini S, Girolami M, Ceccarelli F (1985) The surgical treatment of infantile flat foot. A new expanding endo-orthotic implant. Ital J Orthop Traumatol 11(3):315–322PubMed

67.

Sena P, Manfredini G, Barbieri C, Mariani F, Tosi G, Ruozi B et al (2012) Application of poly-L-lactide screws in flat foot surgery: histological and radiological aspects of bio-absorption of degradable devices. Histol Histopathol 27(4):485–496. doi:10.14670/HH-27.485 PubMed

68.

Saxena A, Nguyen A (2007) Preliminary radiographic findings and sizing implications on patients undergoing bioabsorbable subtalar arthroereisis. J Foot Ankle Surg 46(3):175–180. doi:10.1053/j.jfas.2007.01.009 PubMedCrossRef

69.

von Recum HA, Cleek RL, Eskin SG, Mikos AG (1995) Degradation of polydispersed poly(l-lactic acid) to modulate lactic acid release. Biomaterials 16(6):441–447. doi:10.1016/0142-9612(95)98816-W CrossRef

70.

Bali N, Theivendran K, Prem H (2013) Computed tomography review of tarsal canal anatomy with reference to the fitting of sinus tarsi implants in the tarsal canal. J Foot Ankle Surg 52(6):714–716. doi:10.1053/j.jfas.2013.07.008 PubMedCrossRef

71.

Kleipool RP, Blankevoort L, Ruijter JM, Kerkhoffs GMMJ, Oostra RJ (2017) The dimensions of the tarsal sinus and canal in different foot positions and its clinical implications. Clin Anat. doi:10.1002/ca.22908

72.

Nelson SC, Haycock DM, Little ER (2004) Flexible flatfoot treatment with arthroereisis: radiographic improvement and child health survey analysis. J Foot Ankle Surg 43(3):144–155. doi:10.1053/j.jfas.2004.03.012 PubMedCrossRef

73.

Zaret DI, Myerson MS (2003) Arthroerisis of the subtalar joint. Foot Ankle Clin 8(3):605–617PubMedCrossRef

74.

Kuwada GT, Dockery GL (1988) Complications following traumatic incidents with STA-peg procedures. J Foot Surg. 27(3):236–239PubMed

75.

Rockett AK, Mangum G, Mendicino SS (1998) Bilateral intraosseous cystic formation in the talus: a complication of subtalar arthroeresis. J Foot Ankle Surg 37(5):421–425PubMedCrossRef

Title: Bioabsorbable implants for subtalar arthroereisis in pediatric flatfoot
Authors: C. Faldini
A. Mazzotti
A. Panciera
F. Perna
N. Stefanini
S. Giannini
Publication date: 01-04-2018
Publisher: Springer Milan
Published in: MUSCULOSKELETAL SURGERY / Issue 1/2018
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI: https://doi.org/10.1007/s12306-017-0491-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bioabsorbable implants for subtalar arthroereisis in pediatric flatfoot

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2018

Is VEGF under-expressed in Indian children with Perthes disease?

A mini-invasive tenolysis of the flexor tendons following hand fractures: case series

Pedicle screw fixation in thoracolumbar and lumbar spine assisted by lateral fluoroscopic imaging: a study to evaluate the accuracy of screw placement

A comparison between two double-button endoscopically assisted surgical techniques for the treatment acute acromioclavicular dislocations

Acknowledgement to reviewers 2017

Intrawound application of vancomycin changes the responsible germ in elective spine surgery without significant effect on the rate of infection: a randomized prospective study