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.