Skip to main content

Advertisement

SpringerLink
Log in

Use of the arthroereisis screw with tendoscopic delivered platelet-rich plasma for early stage adult acquired flatfoot deformity

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Early stage adult acquired flatfoot deformity (AAFD) is traditionally treated with osteotomy and tendon transfer. Despite a high success rate, the long recovery time and associated morbidity are not sufficient. This study aims to evaluate the functional and radiological outcomes following the use of the arthroereisis screw with tendoscopic delivered PRP for early stage AAFD.

Methods

Patients with stage IIa AAFD who underwent the use of the arthroereisis screw with tendoscopic delivered PRP with a minimum follow-up time of 24 months were retrospectively evaluated. Clinical outcomes for pain were evaluated with the Foot and Ankle Outcomes Score (FAOS) and Visual Analog Score (VAS). Radiographic deformity correction was assessed using weight-bearing imaging.

Results

Thirteen patients (13 feet) with mean follow-up of 29.5 months were included. The mean age was 37.3 years (range, 28–65 years). FAOS-reported symptoms, pain, daily activities, sports activities, and quality of life significantly improved from 52.1, 42.6, 57.6, 35.7, and 15.4 pre-operatively to 78.5, 68.2, 83.3, 65.0, and 49.6 post-operatively, respectively (p < 0.05). Statistically significant radiographic improvements (lateral talus first metatarsal angle, calcaneal pitch, and cuneiform to ground distance) were also observed between the pre- and post-operative images.

Conclusions

This study elucidates the successful implementation of a less invasive approach to stage IIa AAFD. Through the use of a subtalar arthroereisis screw, PTT tendoscopy, and PRP injection, clinical and radiographic outcomes were improved.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Myerson RA (1996) Instructional course lecture, The American Academy of Orthopaedic Surgeons. Adult acquired flatfoot deformity, treatment of dysfunction of the posterior tibial tendon. J Bone Joint Surg Am 78:780–792

    Article  Google Scholar 

  2. Myerson MS, Corrigan J (1996) Treatment of posterior tibial tendon dysfunctionwith flexor digitorum tendon transfer and calcaneal osteotomy. Orthopedics 19(5):383–388

    CAS  PubMed  Google Scholar 

  3. Myerson MS, Badekas A, Schon LC (2004) Treatment of stage II posterior tibial tendon deficiency with flexor digitorum longus tendon transfer and calcaneal osteotomy. Foot Ankle Int 25(7):445–450

    Article  PubMed  Google Scholar 

  4. Kou JX, Balasubramaniam M, Kippe M, Fortin PT (2012) Functional results of posterior tibial tendon reconstruction, calcaneal osteotomy, and gastrocnemius recession. Foot Ankle Int 33(7):602–611

    Article  PubMed  Google Scholar 

  5. Haeseker GA, Mureau MA, Faber FW (2010) Lateral column lengthening for acquired adult flatfoot deformity caused by posterior tibial tendon dysfunction stage II: a retrospective comparison of calcaneus osteotomy with calcaneocuboid distraction arthrodesis. J Foot Ankle Surg 49(4):380–384

    Article  PubMed  Google Scholar 

  6. Grice DS (1952) An extra-articular arthrodesis of the subastragalar joint for correction of paralytic flat feet in Children. J Bone Joint Surg Am 34:927–940

    Article  PubMed  Google Scholar 

  7. Giannini S, Ceccarelli F, Benedetti MG, Cantani F, Faldini C (2001) Surgical treatment of flexible flatfoot in children. J Bone Joint Surg 83A:73–79

    Article  Google Scholar 

  8. Viladot R, Pons M, Alvarez F, Omaña J (2003) Subtalar arthroereisis for posterior tibial tendon dysfunction: a preliminary report. Foot Ankle Int 24(8):600–606

    Article  PubMed  Google Scholar 

  9. Zaret DI, Myerson MS (2003) Arthroerisis of the subtalar joint. Foot Ankle Clin 8(3):605–617

    Article  PubMed  Google Scholar 

  10. Needleman RL (2006) A surgical approach for flexible flatfeet in adults including a subtalar arthroereisis with the MBA sinus tarsi implant. Foot Ankle Int 27(1):9–18

    Article  PubMed  Google Scholar 

  11. Adelman VR, Szczepanski JA, Adelman RP (2008) Radiographic evaluation of endoscopic gastrocnemius recession, subtalar joint arthroereisis, and flexor tendon transfer for surgical correction of stage II posterior tibial tendon dysfunction: a pilot study. J Foot Ankle Surg 47(5):400–408

    Article  PubMed  Google Scholar 

  12. Cook EA, Cook JJ, Basile P (2011) Identifying risk factors in subtalar arthroereisis explantation: a propensity-matched analysis. J Foot Ankle Surg 50:395–401

    Article  PubMed  Google Scholar 

  13. Zhu Y, Xu XY (2015) Treatment of stage II adult acquired flatfoot deformity with subtalar arthroereises. Foot Ankle Spec 8(3):194–202

    Article  PubMed  Google Scholar 

  14. Saxena A, Via AG, Maffulli N, Chiu H (2016) Subtalar arthroereisis implant removal in adults: a prospective study of 100 patients. J Foot Ankle Surg 55(3):500–503

    Article  PubMed  Google Scholar 

  15. Zhang J, Wang JH (2010) Platelet-rich plasma releasate promotes differentiation of tendon stem cells into active tenocytes. Am J Sports Med 38(12):2477–2486

    Article  PubMed  Google Scholar 

  16. Wang A, McCann P, Colliver J, Koh E, Ackland T, Joss B, Zheng M, Breidahl B (2015) Do postoperative platelet-rich plasma injections accelerate early tendon healing and functional recovery after arthroscopic supraspinatus repair? A randomized controlled trial. Am J Sports Med 43(6):1430–1437

    Article  PubMed  Google Scholar 

  17. Gianakos AL, Ross KA, Hannon CP, Duke GL, Prado MP, Kennedy JG (2015) Functional outcomes of tibialis posterior tendoscopy with comparison to magnetic resonance imaging. Foot Ankle Int 36(7):812–819

    Article  PubMed  Google Scholar 

  18. van Dijk CN, Kort N, Scholten PE (1997) Tendoscopy of the posterior tibial tendon. Arthroscopy 13(6):692–698

    Article  PubMed  Google Scholar 

  19. Sammarco VJ (2009) Peroneal tendoscopy: indications and techniques. Sports Med Arthrosc 17(2):94–99

    Article  PubMed  Google Scholar 

  20. Mani SB, Brown HC, Nair P, Chen L, Do HT, Lyman S, Deland JT, Ellis SJ (2013) Validation of the foot and ankle outcome score in adult acquired flatfoot deformity. Foot Ankle Int 34(8):1140–1146

    Article  PubMed  Google Scholar 

  21. O’Connor K, Baumhauer J, Houck JR (2010) Patient factors in the selection of operative vs nonoperative treatment for posterior tibial tendon dysfunction. Foot Ankle Int 31:197–202

    Article  PubMed  Google Scholar 

  22. Hirose CB, Johnson JE (2004) Plantar flexion opening wedge medial cuneiform osteotomy for correction of fixed forefoot varus associated with flatfoot deformity. Foot Ankle Int 25(8):568–574

    Article  PubMed  Google Scholar 

  23. Thomas RL, Wells BC, Garrison RL, Prada SA (2001) Preliminary results comparing two methods of lateral column lengthening. Foot Ankle Int 22:107–119

    CAS  PubMed  Google Scholar 

  24. Chou LW, Hsieh YL, Kuan TS, Hong CZ (2014) Needling therapy for myofascial pain: recommended technique with multiple rapid needle insertion. Biomedicine (Taipei) 4(13):Epub Aug 2

  25. Baksh N, Hannon CP, Murawski CD, Smyth NA, Kennedy JG (2013) Platelet-rich plasma in tendon models: a systematic review of basic science literature. Arthroscopy 29(3):596–607

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan

    Youichi Yasui, Masato Takao & Hirotaka Kawano

  2. Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA

    Youichi Yasui, Ichiro Tonogai, Andrew J. Rosenbaum, David M. Moore & John G. Kennedy

  3. Department of Orthopedic Surgery, Tokushima University, Tokushima, Japan

    Ichiro Tonogai

  4. Royal College of Surgeons in Ireland, Dublin, Ireland

    David M. Moore

Authors
  1. Youichi Yasui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ichiro Tonogai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew J. Rosenbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David M. Moore
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Masato Takao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hirotaka Kawano
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. John G. Kennedy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John G. Kennedy.

Ethics declarations

Conflict of interest

The corresponding author (J.G. Kennedy ) is a consultant for Arteriocyte, Inc.; J.G. Kennedy has received research support from the Ohnell Family Foundation, Mr. and Mrs. Michael J Levitt, and Arteriocyte Inc.; J.G. Kennedy is a board member for the European Society of Sports Traumatology, Knee Surgery, and Arthroscopy, International Society for Cartilage Repair of the Ankle, American Orthopaedic Foot and Ankle Society Awards and Scholarships Committee, International Cartilage Repair Society finance board.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yasui, Y., Tonogai, I., Rosenbaum, A.J. et al. Use of the arthroereisis screw with tendoscopic delivered platelet-rich plasma for early stage adult acquired flatfoot deformity. International Orthopaedics (SICOT) 41, 315–321 (2017). https://doi.org/10.1007/s00264-016-3349-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-016-3349-2

Keywords

Search

Navigation