Does the medial longitudinal arch collapse recur after subtalar arthroereisis implant removal? A long-term follow-up study in adolescents.

IF 2 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-10-07 DOI:10.1016/j.fas.2025.10.003

Yang Xu, Xingchen Li, Linting Huang, Xiangyang Xu, Yunfeng Yang

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引用次数: 0

Abstract

Background: Flexible flatfoot is a common pediatric condition characterized by a reducible loss of the medial longitudinal arch during weight-bearing. While subtalar arthroereisis is widely used for its minimally invasive correction, long-term outcomes-particularly arch stability after implant removal-remain poorly understood. This study evaluates radiological and functional changes from implant insertion to removal in adolescent flatfoot patients.

Methods: A retrospective analysis of 21 adolescents with flexible flatfoot who underwent subtalar arthroereisis followed by implant removal was conducted. Radiographic parameters (hindfoot valgus angle, talonavicular coverage angle, etc.) and functional scores (AOFAS, VAS) were assessed preoperatively, postoperatively, and at final follow-up (mean 8.2 years).

Results: Subtalar arthroereisis significantly improved deformity and function. The hindfoot valgus angle reduced from 11.6° ± 7.8° to 1.3° ± 4.3° postoperatively, AOFAS score increased from 68.3 ± 6.2-95.5 ± 3.0. The talonavicular coverage angle was 26.2 ± 11.4° preoperatively, decreased to 10.1 ± 5.9° postoperatively. The talar pitch angle was 40.9 ± 6.0° preoperatively, decreased to 29.3 ± 3.4° postoperatively. The calcaneal pitch angle was 14.2 ± 2.2° preoperatively, increased to 16.9 ± 2.9° postoperatively. The lateral Meary's angle was -24.4 ± 6.9° preoperatively, improved to -8.1 ± 3.5° postoperatively. The AOFAS score increased from 68.3 ± 6.2 preoperatively to 95.5 ± 3.0 postoperatively, meanwhile, the VAS score decreased significantly from 3.5 ± 1.2 preoperatively to 1.3 ± 1.1 postoperatively. However, mild arch recurrence occurred after implant removal (The talar pitch angle increased to 32.6 ± 3.3° at the final follow-up. The lateral Meary's angle increased to -12.9 ± 3.6° at the final follow-up after implant removal.), though values remained superior to preoperative levels.

Conclusion: Following subtalar arthroereisis implant removal, adolescents with flexible flatfoot demonstrate mild arch recurrence; nevertheless, radiological outcomes sustain substantial improvement relative to the preoperative condition.

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距下关节挛缩植入物移除后，内侧纵弓塌陷是否复发？一项青少年长期随访研究。

背景：柔性扁平足是一种常见的儿童疾病，其特征是在负重过程中可减轻的内侧纵弓损失。虽然距下关节复位术被广泛用于微创矫正，但其长期效果，特别是移除植入物后的弓稳定性，仍然知之甚少。本研究评估青少年扁平足患者从植入到移除的放射学和功能变化。方法：回顾性分析21例行距下关节挛缩并取出假体的青少年柔性扁平足患者。术前、术后及最终随访（平均8.2年）评估影像学参数（后足外翻角、距舟骨覆盖角等）及功能评分（AOFAS、VAS）。结果：距下关节挛缩明显改善畸形和功能。术后后足外翻角由11.6°±7.8°减小至1.3°±4.3°，AOFAS评分由68.3 ± 6.2 ~ 95.5 ± 3.0升高。距舟骨覆盖角术前为26.2 ± 11.4°，术后降至10.1 ± 5.9°。距骨俯仰角术前为40.9 ± 6.0°，术后降至29.3 ± 3.4°。跟骨俯仰角术前为14.2 ± 2.2°，术后增至16.9 ± 2.9°。术前Meary's侧角为-24.4 ± 6.9°，术后改善为-8.1 ± 3.5°。AOFAS评分由术前68.3 ± 6.2分上升至术后95.5 ± 3.0分，VAS评分由术前3.5 ± 1.2分下降至术后1.3 ± 1.1分。然而，种植体移除后出现轻度弓复发（最终随访距距角增加到32.6 ± 3.3°）。在植入物取出后的最后随访中，侧侧Meary's角增加到-12.9 ± 3.6°)，但数值仍优于术前水平。结论：距下关节假体移除后，青少年柔性平足有轻度足弓复发；然而，放射学结果相对于术前状况有了实质性的改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.