Abstract
The present multicenter, prospective study evaluated the subjective outcomes in patients
after extraosseous talotarsal stabilization using the HyProCure® stent as a standalone procedure for the treatment of recurrent and/or partial talotarsal
joint dislocation (RTTD) in a population of pediatric and adult patients. RTTD has
been cited as a possible etiology for a number of foot ailments and might contribute
to the development of pathologic features localized more proximally in the weightbearing
musculoskeletal chain. Correction of RTTD might, therefore, lead to the reduction
of pathologic features associated with this deformity. A total of 46 feet in 35 patients
were included in the present investigation. Subjective evaluation used the Maryland
Foot Score assessment, which was obtained preoperatively and 1, 2, and 3 weeks, 1,
2, 3, and 6 months, and 1 year postoperatively. The mean overall scores improved from
a preoperative value of 69.53 ± 19.56 to a postoperative value of 89.17 ± 14.41 at
the 1-year follow-up. Foot pain decreased by 36.97%, foot functional activities improved
by 14.39%, and foot appearance improved by 29.49%. The greatest magnitude of improvement
occurred 4 weeks postoperatively, with gradual improvement continuing through to the
1-year follow-up. Implants were removed from 2 patients (2 feet, 4.35%). No unresolved
complications were observed. The positive subjective outcomes resulting from the extraosseous
talotarsal stabilization procedure suggest that the intervention employing the device
we have described alleviates pain and improves foot function and appearance in patients
with RTTD.
Level of Clinical Evidence
Keywords
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 accessOne-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:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Biomechanics of the tarsal mechanism: a key to the function of the normal human foot.J Am Podiatr Med Assoc. 2000; 90: 12-17
- Biomedical gait evaluation of the immediate effect of orthotic treatment for flexible flat foot.Prosthet Orthot Int. 1998; 22: 25-34
- The midtarsal joint locking mechanism.Foot Ankle Int. 2005; 26: 1074-1080
- Effect of feet hyperpronation on pelvic alignment in a standing position.Gait Posture. 2007; 25: 127-134
- Kinematic and isokinetic evaluation of patients with flat foot.Ital J Orthop Traumatol. 1992; 18: 241-251
- The influence of the foot-ankle complex on the proximal skeletal structures.Artif Limbs. 1969; 13: 59-65
- Global body posture evaluation in patients with temporomandibular joint disorder.Clinics (Sao Paulo). 2009; 64: 35-39
- A note on posture in relation to flat feet.J Bone Joint Surg Am. 1933; 15: 787-788
- The relationship of abnormal pronation to chondromalacia of the patella in distance runners.J Am Podiatry Assoc. 1979; 69: 159-162
- The effect of excessive subtalar joint pronation on patellofemoral mechanics: a theoretical model.J Orthop Sports Phys Ther. 1987; 9: 160-165
- Association of flat feet with knee pain and cartilage damage in older adults.Arthritis Care Res. 2011; 63: 937-944
- Biomechanics of the Normal and Abnormal Foot.J Am Podiatr Med Assoc. 2000; 90: 30-34
- Hyperpronation and foot pain: steps toward pain-free feet.Phys Sports Med. 2004; 32: 19-26
- Subtalar joint arthroereisis with SILASTIC silicone sphere: a retrospective study.J Foot Surg. 1992; 31: 47-51
- A modified subtalar arthroereisis implant for the correction of flexible flatfoot in children: the STA peg procedure.Clin Podiatr Med Surg. 1989; 6: 585-590
- Subtalar joint axis location and rotational equilibrium theory of foot function.J Am Podiatr Med Assoc. 2001; 91: 465-487
- Tibialis posterior tendon dysfunction.Clin Orthop Relat Res. 1989; 239: 196-206
- Extraosseous talotarsal stabilization using HyProCure® in adults: a 5-year retrospective follow-up.J Foot Ankle Surg. 2012; 51: 23-29
- Radiographic evaluation of navicular position in the sagittal plane-correction following an extraosseous talotarsal stabilization procedure.J Foot Ankle Surg. 2011; 50: 551-557
- Stabilization of joint forces of the subtalar complex via HyProCure sinus tarsi stent.J Am Podiatr Med Assoc. 2011; 101: 390-399
- Extraosseous talotarsal stabilization devices: a new classification system.J Foot Ankle Surg. 2012; 51: 613-619
- Posterior tibial tendon insufficiency results at different stages.Musculoskelet J Hospital Special Surg. 2006; 2: 157-160
- Radiographic values of the adult foot in a standardized population.J Foot Ankle Surg. 2006; 45: 3-12
- Normal biomechanics of the adult rearfoot: a radiographic analysis.J Am Podiatr Assoc. 1976; 66: 812-824
- Operative treatment in 120 displaced intraarticular calcaneal fractures: results using a prognostic computed tomography scan classification.Clin Orthop. 1993; 290: 87-95
Ware JE. SF-36 Health Survey: Manual and Interpretations Guide, Health Institute, New England Medical Center, Boston, 1993.
- A comparison of outcome scores in os calcis fractures.Ir J Med Sci. 2000; 169: 127-128
- Outcome of surgically treated intraarticular calcaneus fractures—SF-36 compared with AOFAS and MFS.Acta Orthop Scand. 2004; 75: 750-755
- Clinical outcome scoring of intra-articular calcaneal fractures.J Foot Ankle Surg. 2008; 47: 213-218
- Z-bunionectomy: retrospective long-term study.J Foot Ankle Surg. 1996; 35: 312-317
Farabeuf LH. Precis de Manuel Operatoire, Ligatures, Amputations. G. Masson, Paris, 1893.
- Evaluation of the University of California Biomechanics Laboratory shoe insert in “flexible” pes planus.Clin Orthop Relat Res. 1972; 82: 45-58
- Conservative management of pes valgus with plantar flexed talus, flexible.Clin Orthop Relat Res. 1977; 122: 85-94
- Pes planus: radiographic changes with foot orthoses and shoes.Foot Ankle. 1982; 2: 299-303
- Corrective shoes and inserts as treatment for flexible flatfoot in infants and children.J Bone Joint Surg Am. 1989; 71: 800-810
- Soft tissue procedures for the stabilization of medial arch pathology in the management of flexible flatfoot deformity.Clin Podiatr Med Surg. 2007; 24: 657-665
- Isolated medial column stabilization improves alignment in adult-acquired flatfoot.Clin Orthop Related Res. 2005; 435: 197-202
- Randomized prospective study comparing tri-cortical iliac crest autograft to allograft in the lateral column lengthening component for operative correction of adult acquired flatfoot deformity.Foot Ankle Int. 2007; 28: 8-12
- The stop screw technique—a simple and reliable method in treating flexible flatfoot in children.Foot Ankle Surg. 2009; 15: 174-178
- Subtalar arthrodesis with flexor digitorum longus transfer and spring ligament repair for treatment of posterior tibial tendon insufficiency.Foot Ankle Int. 2000; 21: 722-729
- Operative treatment of the difficult stage 2 adult acquired flatfoot deformity.Foot Ankle Clin North Am. 2001; 6: 95-119
- Operative management options for symptomatic flexible adult acquired flatfoot deformity: a review.Knee Surg Sports Traumatol Arthrosc. 2010; 18: 135-142
- Subtalar joint arthrodesis.Clin Podiatr Med Surg. 2012; 29: 67-75
- Triple arthrodesis for the adult-acquired flatfoot deformity.Clin Podiatr Med Surg. 2007; 24: 765-778
- Complications of surgical treatments for adult flatfoot deformities.Foot Ankle Clin. 2001; 6: 179-191
- A surgical approach for flexible flatfeet in adults including a subtalar arthroereisis with the MBA sinus tarsi implant.Foot Ankle Int. 2006; 27: 9-18
- Subtalar arthroereisis: a new exploration of an old concept.Foot Ankle Clin. 2007; 12: 329-339
- Effect of extra-osseous talotarsal stabilization on posterior tibial tendon strain in hyperpronating feet.J Foot Ankle Surg. 2011; 50: 676-681
- Evaluating plantar fascia strain in hyperpronating cadaveric feet following an extra-osseous talotarsal stabilization procedure.J Foot Ankle Surg. 2011; 50: 682-686
Graham ME, Jawrani NT, Chikka A, Rogers RJ., Surgical treatment of hyperpronation using an extraosseous talotarsal stabilization device: radiographic outcomes in 70 adult patients. J Foot Ankle Surg, 2012. 51(5): p. 548-55.
- Effect of extra-osseous talotarsal stabilization on posterior tibial nerve strain in hyperpronating feet: a cadaveric evaluation.J Foot Ankle Surg. 2011; 50: 672-675
- The effect of HyProCure® sinus tarsi stent on tarsal tunnel compartment pressures in hyperpronating feet.J Foot Ankle Surg. 2011; 50: 44-49
- Subtalar arthroereisis for posterior tibial tendon dysfunction: a preliminary report.Foot Ankle Int. 2003; 24: 600-606
- Arthroereisis of the subtalar joint.Foot Ankle Clin. 2003; 8: 605-617
- Subtalar joint arthroereisis in the management of pediatric flexible flatfoot: a critical review of the literature.Foot Ankle Int. 2011; 32: 1127-1139
Article info
Publication history
Published online: January 14, 2013
Footnotes
Financial Disclosure: Drs. Bresnahan and Chariton conceived the investigation, performed some of the surgeries, and wrote the report. Neither Dr. Bresnahan nor Dr. Chariton received any financial support from Graham International Implant Institute or GraMedica, Macomb, MI, in return for their participation in this investigation.
Conflict of Interest: Anuja Vedpathak, MS, is an employee of the Graham International Implant Institute, Macomb, MI. At the request of the authors, she collated and performed the statistical analysis on the data received from the MFS questionnaires. She also assisted with background research on prior studies.
Identification
Copyright
© 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
