Abstract
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
Keywords
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References
- 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
- 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
- The role of isolated gastrocnemius and combined Achilles contracture in the flatfoot.Foot Ankle Clin North Am. 2007; 12: 363-379
- A modified gastrocnemius lengthening.J Am Podiatr Assoc. 1978; 68: 31-37
- A biomechanical model of the effect of subtalar arthroereisis on the adult flexible flat foot.Clin Biomech. 2004; 19: 847-852
- Flexible flatfoot treatment with arthroereisis: radiographic improvement and child health survey analysis.J Foot Ankle Surg. 2004; 43: 144-155
- Arthroereisis of the subtalar joint.Foot Ankle Clin North Am. 2003; 8: 605-617
- 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
- Arthroereisis-subtalar, Ch. 23.in: Jay R.M. Pediatric Foot & Ankle Surgery. W.B. Saunders Company, Philadelphia1999: 182-191
- 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
- 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
- Use of the Maxwell-Brancheau arthroereisis implant for the correction of posterior tibial tendon dysfunction.Clin Podiatr Med Surg. 1999; 16: 479-489
- Calcaneal valgus deformity.J Bone Joint Surg (Br). 1975; 57B: 270-278
- Clinical biomechanical evaluation of the foot.J Am Podiatr Assoc. 1975; 65: 732-755
- The Maxwell-Brancheau arthroereisis (MBA) implant in pediatric and adult flexible flatfoot conditions.Foot Ankle Q. 1999; 12: 107-119
Maxwell J, Brancheau S. Surgical protocol for subtalar MBA implant. Kinetikos Medical Incorporated, pp 1–5.
- Adult acquired flat foot deformity: clinical and radiographic examination.Foot Ankle Clin. 2003; 8: 431-452
- 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
- Use of the Maxwell-Brancheau arthroereisis implant for the correction of posterior tibial tendon dysfunction.Tech Orthop. 2000; 15: 184-196
- The Evans calcaneal osteotomy for correction of flexible flatfoot syndrome.J Foot Ankle Surg. 1984; 23: 291-301
- The Cotton osteotomy: indications and techniques.Foot Ankle Clin North Am. 2007; 12: 309-315
- Preliminary results comparing two methods of lateral column lengthening.Foot Ankle. 2001; 22: 107-109
- Treatment of painful pediatric flatfoot with Maxwell-Brancheau subtalar arthroereisis implant a retrospective radiographic review.Foot Ankle Spec. 2010; 3: 67-72
- Identifying risk factors in subtalar arthroeresis explantation: a propensity matched analysis.J Foot Ankle Surg. 2011; 50: 395-401
- Subtalar arthroeresis: a new exploration of an old concept.Foot Ankle Clin. 2007; 12: 329-339
Article info
Footnotes
Financial Disclosure: S.P.B. receives royalties from all MBA implants.
Conflict of Interest: None reported.
Identification
Copyright
© 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.