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

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

      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

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      References

        • 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