ACFAS Research Studies

Subtalar Joint Endoprosthesis for Flexible Flatfoot: Patient and Provider Determinants of Favorable and Unfavorable Mid-term Outcomes
This important research initiative led by principal investigator, Adam E. Fleischer, DPM, MPH, FACFAS, is a multi-center retrospective study currently looking at predictive variables associated with successful and unsuccessful outcomes when performing subtalar joint arthroereisis in adults and children. As results are made available, they will be shared with membership.

A Multi-Center Retrospective Review of Outcomes for Arthrodesis, Hemi-Metallic Joint Implant, and Resectional Arthroplasty in the Surgical Treatment of End-Stage Hallux Rigidus
This is a retrospective, multi-center study examining the long-term results for the treatment of end-stage hallux rigidus utilizing three different surgical procedures.

A total of 158 subjects (105 females, 53 males) were included in this study who had undergone one of the following surgical procedures: arthrodesis, hemi-implant, or resectional arthroplasty. The long-term results for subjective assessment of pain, function and alignment as well as objective radiographic and physical findings were examined. The median weeks to post-operative follow-up for the three procedure groups was 159 weeks. There was no statistically significant difference in age or the number of subjects included between the thre treatment groups (p=0.11, p=0.16 respectively). The body mass index was statistically different between the three treatment groups with the hemi-implant group representing a smaller body mass index as compared with the other procedures (p=0.007). No statistically significant difference was found in the subjective outcomes between the three treatment groups utilizing the American College of Foot and Ankle Surgeons' First Metatarsophalangeal Joint and First Ray Scoring Scale (Patient Questionnaire) or the modified Hallux Metatarsophalangeal-Interphalangeal Scale of the American Orthopedic Foot and Ankle Society (p=0.64, p=O.l4 respectively). Further, the correlation coefficient between the two subjective scoring scales was 0.78 which is statistically "1 significant reflecting a moderate to high correlation (p=4.96 x 1 o-34). The results of the radiographic and clinical evaluation revealed that metatarsalgia was the most common finding for the arthrodesis group (9.8 percent ), bony overgrowth into the joint for the hemi-implant group (28.3 percent), and floating hallux for the resectional arthroplasty group (30.9 percent).

The results of our study suggest that all three surgical procedure options are equivalent and viable options for the treatment of end-stage hallux rigidus.