Original Research| Volume 51, ISSUE 1, P3-8, January 2012

An Analysis of Outcomes after Use of the Maxwell-Brancheau Arthroereisis Implant


      The authors present a retrospective study of 35 consecutive patients (60 feet) treated with the Maxwell-Brancheau Arthroereisis (MBA) implant. The mean age of the cohort at the time of surgery was 14.3 (range 5 to 46) years, and 22 (62.86%) men and 13 (37.14%) women were included. Preoperative and postoperative anteroposterior and lateral foot radiographs were compared at a mean of 36 (range 18 to 48) months postoperatively, and the following mean changes were reported: talocalcaneal angle 24.15° ± 7.97° to 18.53° ± 8.23°, calcaneocuboid angle 18.67° ± 8.72° to 11.76° ± 8.49°, first to second intermetatarsal angle 9.42° ± 2.67° to 7.61° ± 2.69°, calcaneal inclination angle 11.93° ± 6° to 14.93° ± 5.85°, and talar declination angle 34.0° ± 8.59° to 28.02° ± 6.85°; all of these differences were statistically significant (p < .0001). A subgroup of 24 (68.57%) patients also answered a subjective questionnaire at a mean of 33 (range 12 to 55) months postoperatively. The presenting chief complaints were resolved in 23 patients (95.83%) of the subgroup, and 21 patients (87.5%) returned postoperatively to either the same or a greater activity level in sports. Twenty-three (95.83% of the subgroup) patients said they were 75% to 100% satisfied with their surgical outcome, and that they would recommend the surgery to a friend or family member with the same condition, whereas 1 (4.17%) claimed 0% satisfaction after placement of inappropriately sized implants (which were later replaced to the patient’s clinical satisfaction) in both feet.

      Level of Clinical Evidence


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mahan K.T.
        Pes planovalgus deformity.
        in: Banks A.S. Downey M.S. Martin D.E. Miller S.J. 2nd ed. Comprehensive Textbook of Foot Surgery. vol. 1. Williams & Wilkins, Baltimore1992: 769-817
        • Mann R.A.
        Flatfoot in adults, Ch. 16.
        in: Coughlin M.J. Mann R.A. 7th ed. Surgery of the Foot and Ankle. vol. 1. Mosby, St. Louis1999: 733-767
        • DiGiovanni C.
        • Langer P.
        The role of isolated gastrocnemius and combined Achilles contracture in the flatfoot.
        Foot Ankle Clin North Am. 2007; 12: 363-379
        • Schoenhaus H.D.
        • Jay R.M.
        A modified gastrocnemius lengthening.
        J Am Podiatr Assoc. 1978; 68: 31-37
        • Arangio G.A.
        • Reinert K.L.
        • Salathe E.P.
        A biomechanical model of the effect of subtalar arthroereisis on the adult flexible flat foot.
        Clin Biomech. 2004; 19: 847-852
        • Nelson S.C.
        • Haycock D.M.
        • Little E.R.
        Flexible flatfoot treatment with arthroereisis: radiographic improvement and child health survey analysis.
        J Foot Ankle Surg. 2004; 43: 144-155
        • Zaret D.I.
        • Myerson M.S.
        Arthroereisis of the subtalar joint.
        Foot Ankle Clin North Am. 2003; 8: 605-617
        • Bruyn J.M.
        • Cerniglia M.W.
        • Chaney D.M.
        Combination of Evans calcaneal osteotomy and STA-Peg arthroereisis for correction of the severe pes valgo planus deformity.
        J Foot Ankle Surg. 1999; 38: 339-346
        • Jay R.M.
        Arthroereisis-subtalar, Ch. 23.
        in: Jay R.M. Pediatric Foot & Ankle Surgery. W.B. Saunders Company, Philadelphia1999: 182-191
        • Miller S.J.
        The MBA subtalar joint arthroereisis implant in the adult flexible flatfoot: preliminary data and experience.
        in: Vickers N.S. Miller S.J. Mahan K.T. Reconstructive Surgery of the Foot and Leg, Update ’98. The Podiatry Institute Publishing, Tucker, GA1998: 13-18
        • Maxwell J.
        • Knudson W.
        • Cerniglia M.
        The MBA arthroereisis implant: early prospective results.
        in: Vickers N.S. Reconstructive Surgery of the Foot and Leg, Update ’97. The Podiatry Institute Publishing, Tucker, GA1997: 256-264
        • Maxwell J.R.
        • Armando C.
        • Sun C.
        Use of the Maxwell-Brancheau arthroereisis implant for the correction of posterior tibial tendon dysfunction.
        Clin Podiatr Med Surg. 1999; 16: 479-489
        • Evans D.
        Calcaneal valgus deformity.
        J Bone Joint Surg (Br). 1975; 57B: 270-278
        • Green D.R.
        • Sgarlato T.E.
        • Wittenberg M.
        Clinical biomechanical evaluation of the foot.
        J Am Podiatr Assoc. 1975; 65: 732-755
        • Dockery G.L.
        The Maxwell-Brancheau arthroereisis (MBA) implant in pediatric and adult flexible flatfoot conditions.
        Foot Ankle Q. 1999; 12: 107-119
      1. Maxwell J, Brancheau S. Surgical protocol for subtalar MBA implant. Kinetikos Medical Incorporated, pp 1–5.

        • Meehan R.E.
        • Brage M.
        Adult acquired flat foot deformity: clinical and radiographic examination.
        Foot Ankle Clin. 2003; 8: 431-452
        • Maxwell J.
        Subtalar joint arthroereisis.
        in: Banks A.S. Downey M.S. Martin D.E. Miller S.J. 3rd ed. Comprehensive Textbook of Foot Surgery. vol. 1. Williams and Wilkins, Baltimore2001: 901-914
        • Maxwell J.
        • Nakra A.
        • Nakra A.
        • Ashley C.
        Use of the Maxwell-Brancheau arthroereisis implant for the correction of posterior tibial tendon dysfunction.
        Tech Orthop. 2000; 15: 184-196
        • Dollard M.
        • Marcinko D.
        • Lazerson A.
        • Elleby D.
        The Evans calcaneal osteotomy for correction of flexible flatfoot syndrome.
        J Foot Ankle Surg. 1984; 23: 291-301
        • Tankson C.J.
        The Cotton osteotomy: indications and techniques.
        Foot Ankle Clin North Am. 2007; 12: 309-315
        • Thomas R.
        • Wells B.
        • Garrison R.
        • Prada S.
        Preliminary results comparing two methods of lateral column lengthening.
        Foot Ankle. 2001; 22: 107-109
        • Scharer B.
        • Black B.
        • Sockrider N.
        Treatment of painful pediatric flatfoot with Maxwell-Brancheau subtalar arthroereisis implant a retrospective radiographic review.
        Foot Ankle Spec. 2010; 3: 67-72
        • Cook E.
        • Cook J.
        • Basile P.
        Identifying risk factors in subtalar arthroeresis explantation: a propensity matched analysis.
        J Foot Ankle Surg. 2011; 50: 395-401
        • Schon L.
        Subtalar arthroeresis: a new exploration of an old concept.
        Foot Ankle Clin. 2007; 12: 329-339