Symptomatic Flat Foot In Teenagers:

Our Experience In Treatment With

Arthroereisis

Authors: Cristián Ortiz, Emilio Wagner, Andrés Keller, Diego

Zanolli, Amanda Riquelme, Pablo Wagner, Pablo Mocoçain,

Ximena Ahumada

Clínica Alemana de Santiago-Universidad del Desarrollo

Santiago. Chile

Symptomatic Flat Foot In Teenagers:

Our Experience In Treatment With

Arthroereisis

Emilio Wagner H

My disclosure is in the

Final AOFAS Mobile App.

I have no potential conflicts with

this presentation

Introduction

• Initial management:

conservative

• If it fails surgery

– Tendon transferences

– Osteotomies

– Arthrodesis

– Arthroereisis

• Extraarticular procedures

are recommended

because they preserve

the joint surface

Fernandez de Retana, Alvarez, Viladot. Foot Ankle Clin.

2010 Jun;15(2):323-35

Objectives

• To describe multiple arthroereisis

techniques, with their respective clinical,

functional and radiologic results

Methods

Retrospective Study

• Teenager symptomatic flat foot

• Surgery between 2008 and 2013

Methods

• Surgical technique: Calcaneo Stop, Kalix™, Sinus™

• Clinic and radiographic results

• VAS, function, and AOFAS post op score

• Short and medium term follow up (6– 48 months)

Technique example:

Calcaneo Stop

Results • 17 foot (9 patients)

– 11 arthroereisis with

Kalix™

– 2 arthroereisis with

Sinus™

– 4 Calcaneo Stop

• Resection of the

coalition before the

arthroereisis in:

– 2 Kalix™

– 2 Sinus™

Results

• Clinic and radiologic correction in 15/17

• 4 implants (2 Kalix™, 2 Sinus™) needed to be

removed because of pain

• 17/17 VAS 0/10, performing sports

• AOFAS Score: 92 points average (60-100)

Discussion

• Arthroereisis good alternative in

symptomatic flat foot

– Excellent radiological and

clinical outcomes

– Mechanical and proprioceptive

effect

– Low morbidity

– Remodelling the foot anatomy in

children and adolescents

Schon LC. Foot Ankle Clin. 2007 Jun;12(2):329-39

Discussion

• There is no gold standard

– Important: to preserve the articular surface

and bone stock

Roth S, Sestan B, Tudor A, et al. Foot Ankle Int

2007;28:991–5

PRE OP POST OP

Discusion

• Arthroereisis:

– Good results

– Low complication rate

• Using single screw (like

“Calcaneo Stop”)

– Low cost compared with

other techniques

evaluated

– Our choice when

performing arthroereisis

Usuelli FG, Montrasio UA. Foot Ankle Clin. 2012

Jun;17(2):183-94

References

• Schon LC. Subtalar arthroereisis: a new exploration of an old concept. Foot

Ankle Clin. 2007 Jun;12(2):329-39

• Fernandez de Retana, Alvarez, Viladot. Subtalar arthroereisis in pediatric

flatfoot reconstruction. Foot Ankle Clin. 2010 Jun;15(2):323-35

• Mosca VS. Flexible flatfoot and tarsal coalition. In: Canale ST, editor.

Orthopedic knowledge update: pediatrics 2. Chicago (IL): American

Academy of Orthopaedic Surgeons; 2002. p. 215–7

• Roth S, Sestan B, Tudor A, et al. Minimally invasive calcaneo-stop method

for idiopathic, flexible pes planovalgus in children. Foot Ankle Int

2007;28:991–5

• Usuelli FG, Montrasio UA. The calcaneo-stop procedure. Foot Ankle Clin.

2012 Jun;17(2):183-94

• Alvarez R. Calcaneo stop. Tecnica personal original para el tratamiento

quirurgico del pie plano-valgo del niño y del adolescente joven. In:

Epeldegui T, editor. Pie plano y anomalıas del antepie, Madrid, Spain:

Madrid Vicente; 1995. p. 174–7