Abstract
Talocalcaneal joint middle facet coalition is the most common tarsal coalition, occurring
in ≤2% of the population. Fewer than 50% of involved feet obtain lasting relief of
symptoms after nonoperative treatment, and surgical intervention is commonly used
to relieve symptoms, increase the range of motion, improve function, reconstruct concomitant
pes planovalgus, and prevent future arthrosis from occurring at the surrounding joints.
Several approaches to surgical intervention are available for patients with middle
facet coalitions, ranging from resection to hindfoot arthrodesis. We present a series
of 4 cases, in 3 adolescent patients, of talocalcaneal joint middle facet coalition
resection with interposition of a particulate juvenile hyaline cartilaginous allograft
(DeNovo® NT Natural Tissue Graft, Zimmer, Inc., Warsaw, IN). With a mean follow-up period
of 42.8 ± 2.9 (range 41 to 47) months, the 3 adolescent patients in the present series
were doing well with improved subtalar joint motion and decreased pain, and 1 foot
showed no bony regrowth on a follow-up computed tomography scan. The use of a particulate
juvenile hyaline cartilaginous allograft as interposition material after talocalcaneal
middle facet coalition resection combined with adjunct procedures to address concomitant
pes planovalgus resulted in good short-term outcomes in 4 feet in 3 adolescent patients.
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
- Pediatric and adolescent flatfoot reconstruction in combination with middle facet talocalcaneal coalition resection.Clin Podiatr Med Surg. 2010; 27: 119-133
- Tarsal coalitions: etiology, diagnosis, imaging, and stigmata.Clin Podiatr Med Surg. 2010; 27: 105-117
- Diagnosis and treatment of pediatric flatfoot.J Foot Ankle Surg. 2004; 43: 341-373
- Rigid pediatric pes planovalgus: conservative and surgical treatment options.Clin Podiatr Med Surg. 2010; 27: 79-92
- A review of tarsal coalition and pes planovalgus: clinical examination, diagnostic imaging, and surgical planning.J Foot Ankle Surg. 2010; 49: 274-293
- Bilateral single-stage middle facet talocalcaneal coalition resection combined with flatfoot reconstruction: a report of 3 cases and review of the literature. Investigations involving middle facet coalitions—part I.J Foot Ankle Surg. 2008; 47: 180-190
- The presence of calcaneal fibular remodeling associated with middle facet talocalcaneal coalition: a retrospective CT review of 35 feet. Investigations involving middle facet coalitions—part II.J Foot Ankle Surg. 2008; 47: 288-294
- Clinical diagnosis and assessment of the pediatric pes planovalgus deformity.Clin Podiatr Med Surg. 2010; 27: 43-58
- Resection of talocalcaneal middle facet coalition—interposition with a tensor fascia lata allograft: a case report.J Foot Ankle Surg. 2000; 39: 336-340
- Interposition of the split flexor hallucis longus tendon after resection of a coalition of the middle facet of the talocalcaneal joint.J Bone Joint Surg Am. 1999; 81-A: 11-19
- Talocalcaneal bar resection.J Foot Ankle Surg. 1998; 37: 199-203
- Resection of middle facet coalition with arthroscopic guidance.J Foot Ankle Surg. 2009; 48: 273-276
- A critical evaluation of subtalar joint arthrosis associated with middle facet talocalcaneal coalition in 21 surgically managed patients: a retrospective computed tomography review. Investigations involving middle facet coalitions—part III.Clin Podiatr Med Surg. 2010; 27: 135-143
- Gait abnormalities following resection of talocalcaneal coalition.J Bone Joint Surg Am. 1997; 79-A: 369-374
- Operative treatment of flatfoot with talocalcaneal coalition.Clin Orthop. 2003; 411: 178-187
- Tarsal coalition.in: Banks A.S. Downey M.S. Martin D.E. Miller S.J. McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery. ed 3. Lippincott Williams and Wilkins, Philadelphia2001: 993-1031
- Particulated juvenile articular cartilage allograft transplantation for osteochondral lesions of the talus.Techn Foot Ankle. 2011; 10: 92-98
- 2-Year postoperative evaluation of a patient with a symptomatic full-thickness patellar cartilage defect repaired with particulated juvenile cartilage tissue.J Knee Surg. 2010; 23: 109-114
- Chondral defect repair with particulated juvenile cartilage allograft.Cartilage. 2011; 2: 346-353
- Particulated juvenile articular cartilage graft (DeNovo NT Graft) for treatment of osteochondral lesions of the talus.Foot Ankle Spec. 2010; 3: 361-364
- Treatment of osteochondral lesions of the talus with particulated juvenile cartilage.Foot Ankle Int. 2013; 34: 1205-1211
- Particulated juvenile articular cartilage allograft transplantation for osteochondral lesions of the talus.Foot Ankle Clin N Am. 2013; 18: 79-87
- Arthroscopic DeNovo NT® juvenile allograft cartilage implantation in the talus: a case presentation.J Foot Ankle Surg. 2012; 51: 218-221
- Arthroscopic particulated juvenile cartilage allograft transplantation for the treatment of osteochondral lesions of the talus.Arthrosc Tech. 2014; 3: e533-e537
- New frontiers for cartilage repair and protection.Cartilage. 2012; 3: 77S-86S
- Overview of existing cartilage repair technology.Sports Med Arthrosc Rev. 2008; 16: 196-201
- Strategies for articular cartilage lesion repair and functional restoration.Tissue Eng Part B Rev. 2010; 16: 305-329
- Engineering cartilage: from materials to small molecules.in: Li S. L’Heureux N. Elisseeff J.H. Stem Cell and Tissue Engineering. World Scientific Publishing, Singapore2011: 190
- Minced articular cartilage—basic science, surgical technique, and clinical application.Sports Med Arthrosc Rev. 2008; 16: 217-220
Article info
Publication history
Published online: April 24, 2015
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
