Journal of Foot and Ankle Surgery (Asia Pacific)

Register      Login

VOLUME 8 , ISSUE 2 ( April-June, 2021 ) > List of Articles

MINI-SYMPOSIUM: FLATFOOT IN ADULTS

Role of Arthrodesis in Adult-acquired Flatfoot Deformity

Arthithat Kirinpanu

Keywords : Adult-acquired flatfoot deformity, Arthritis, Deformity, Double arthrodesis, Flatfoot, Fusion, Modified double arthrodesis, Posterior tibial tendon dysfunction (PTTD), Triple arthrodesis

Citation Information : Kirinpanu A. Role of Arthrodesis in Adult-acquired Flatfoot Deformity. J Foot Ankle Surg Asia-Pacific 2021; 8 (2):60-65.

DOI: 10.5005/jp-journals-10040-1140

License: CC BY-NC 4.0

Published Online: 00-06-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Adult-acquired flatfoot deformity (AAFD) is composed of multi-structure problems. Failure of tendons, capsular, and other ligamentous structures lead to significant deformity and disability. Several therapeutic approaches are used to treat this disease. Arthrodesis reconstruction type procedure was raised as a satisfactory operation with high patient satisfaction. Ability to reduce most severe and fix deformities made it a procedure of choice in dealing with advance stage AAFD. Malunion, nonunion, lateral wound breakdown, and adjacent joint osteoarthritis are leading problems associated with this operation. However, there are some situations that patient will be best undergone these operations. Realigned triple arthrodesis along with its modifications are currently wide-accepted treatment for rigid arthritic flatfoot. Severe flexible AAFD and failed flatfoot reconstruction while choosing patients properly are also possible indications to treat with the fusion techniques. Lastly, some specific patient factors (age, morbid obesity, preexisting degenerative joint disease, and neuropathic patients) could be important factors to influence type of operations.


PDF Share
  1. Approach and treatment of the adult acquired flatfoot deformity. Curr Rev Musculoskelet Med 2013;6(4):294–303. DOI: 10.1007/s12178-013-9173-z.
  2. An operation for stabilizing paralytic feet. JBJS 1921;3(10):494–507.
  3. Triple arthrodesis in adults. Foot Ankle 1991;12(3):138–143. DOI: 10.1177/107110079101200302.
  4. Triple arthrodesis. A critical long-term review. J Bone Joint Surg Br 1986;68(2):260–265. DOI: 10.1302/0301-620X.68B2.3958012.
  5. Triple arthrodesis. Clin Orthop Relat Res 1999;365:91–99. DOI: 10.1097/00003086-199908000-00012.
  6. Tibialis posterior tendon dysfunction. Clin Orthop Relat Res 1989;239(239):196–206. DOI: 10.1097/00003086-198902000-00022.
  7. Adult-acquired flatfoot deformity. J Am Acad Orthopae Surg 2008;16(7):399–406. DOI: 10.5435/00124635-200807000-00005.
  8. Arthrodesis techniques in the management of stage II and III acquired adult flatfoot deformity. Instr Course Lect 2006;55:531.
  9. Comparison of initial compression force across the subtalar joint by two different screw fixation techniques. J Foot Ankle Surg 2006;45(3):168–173. DOI: 10.1053/j.jfas.2006.02.001.
  10. Optimal double screw configuration for subtalar arthrodesis: a finite element analysis. Knee Surg Sports Traumatol Arthrosc 2011;19(5):842–849. DOI: 10.1007/s00167-010-1383-y.
  11. Biomechanical comparison of screw versus plate/screw construct for talonavicular fusion. Foot Ankle Int 2009;30(2):150–156. DOI: 10.3113/FAI-2009-0150.
  12. Clinical outcome after primary triple arthrodesis. JBJS 2000;82(1):47–57. DOI: 10.2106/00004623-200001000-00006.
  13. Triple arthrodesis in treatment of degenerative hindfoot deformities: Clinical, radiological and pedobarographic results. Z Orthop Unfall 2009;147(3):356–361. DOI: 10.1055/s-0029-1185407.
  14. The medial approach to triple arthrodesis. Indications and technique for management of rigid valgus deformities in high-risk patients. Foot Ankle Clin 2005;10(3):515–521. DOI: 10.1016/j.fcl.2005.04.004.
  15. Mid-to long-term outcome of 96 corrective hindfoot fusions in 84 patients with rigid flatfoot deformity. Bone Joint J 2015;97(5):668–674.
  16. Lower extremity kinematics and kinetics during level walking and stair climbing in subjects with triple arthrodesis or subtalar fusion. Gait Posture 2005;21(3):263–270. DOI: 10.1016/j.gaitpost.2004.02.001.
  17. Long-term results after triple arthrodesis: influence of alignment on ankle osteoarthritis and clinical outcome. Foot Ankle Surg 2019;25(2):247–250. DOI: 10.1016/j.fas.2017.11.003.
  18. Long-term results after a triple arthrodesis of the hindfoot: function and satisfaction in 36 patients. Int Orthop 2008;32(2):237–241. DOI: 10.1007/s00264-006-0295-4.
  19. Motion of the hindfoot after simulated arthrodesis. JBJS 1997;79(2):241–246. DOI: 10.2106/00004623-199702000-00012.
  20. Double arthrodesis in the adult. Clin Orthopaed Relat Res 1999;365:74–80. DOI: 10.1097/00003086-199908000-00010.
  21. Simultaneous calcaneocuboid and talonavicular fusion. Long-term follow-up study. J Bone Joint Surg Br 1994;76(1):133–136. DOI: 10.1302/0301-620X.76B1.8300657.
  22. Management of the rigid adult acquired flatfoot deformity. Foot Ankle Clin 2007;12(2):317–327. DOI: 10.1016/j.fcl.2007.03.013.
  23. Arthrodesis of the subtalar and talonavicular joints for correction of symptomatic hindfoot malalignment. Foot Ankle Int 2006;27(9):661–666. DOI: 10.1177/107110070602700901.
  24. Subtalar and talonavicular arthrodesis through a single medial approach for the correction of severe planovalgus deformity. J Bone Joint Surg Br 2009;91(5):612–615. DOI: 10.1302/0301-620X.91B5.21727.
  25. Single medial approach to modified double arthrodesis in rigid flatfoot with lateral deficient skin. Foot Ankle Int 2009;30(1):21–26. DOI: 10.3113/FAI.2009.0021.
  26. Hindfoot deformity corrected with double versus triple arthrodesis: radiographic comparison. J Foot Ankle Surg. 2015;54(3):424–427.
  27. Increased failure rate of modified double arthrodesis compared with triple arthrodesis for rigid pes planovalgus. J Foot Ankle Surg 2016;55(6):1169–1174.
  28. American college of foot and ankle surgeons clinical consensus statement: appropriate clinical management of adult-acquired flatfoot deformity. J Foot Ankle Surg 2020;59(2):347–355.
  29. Subtalar arthrodesis for treatment of posterior tibial tendon insufficiency. Foot Ankle Clin 2001;6(1):121–128. DOI: 10.1016/S1083-7515(03)00085-8.
  30. Subtalar arthrodesis with flexor digitorum longus transfer and spring ligament repair for treatment of posterior tibial tendon insufficiency. Foot Ankle Int 2000;21(9):722–729. DOI: 10.1177/107110070002100902.
  31. Adult-acquired flatfoot deformity. Foot Ankle Orthopaed 2019;4(1):2473011418820847. DOI: 10.1177/2473011418820847.
  32. Fusion versus flexible reconstruction for patients with flexible flatfoot. Foot Ankle Orthopaed 2018;3(3):2473011418S00516.
  33. Revision of the failed flatfoot. Revision surgery of the foot and ankle, Surg Strateg Techniq 2019. p. 259.
  34. Severe stage 2: fuse or reconstruct. Foot and Ankle Clinics 2017;22(3):637–642.
  35. The undercorrected flatfoot reconstruction. Foot and Ankle Clin 2017;22(3):613–624.
  36. Preliminary results comparing two methods of lateral column lengthening. Foot Ankle Int 2001;22(2):107–119. DOI: 10.1177/107110070102200205.
  37. Hypermobility of the first metatarsal bone in patients with rheumatoid arthritis treated by lapidus procedure. BMC Musculoskelet Disord 2012;13(1):148. DOI: 10.1186/1471-2474-13-148.
  38. Fusion rate of first tarsometatarsal arthrodesis in the modified Lapidus procedure and flatfoot reconstruction. Foot Ankle Int 2005;26(9):698–703. DOI: 10.1177/107110070502600906.
  39. Overcorrected flatfoot reconstruction. Foot Ankle Clin 2017;22(3):597–611.
  40. Nonoperative care for the treatment of adult-acquired flatfoot deformity. J Foot Ankle Surg 2011;50(3):311–314. DOI: 10.1053/j.jfas.2011.02.002.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.