Vescio A, Testa G, Amico M, Lizzio C, Sapienza M, Pavone P, Pavone V. Arthroereisis in juvenile flexible flatfoot: Which device should we implant? A systematic review of literature published in the last 5 years. World J Orthop 2021; 12(6): 433-444 [PMID: 34189081 DOI: 10.5312/wjo.v12.i6.433]
Corresponding Author of This Article
Vito Pavone, MD, PhD, Associate Professor, Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, Via Santa Sofia, 78, Catania 95123, Italy. vitopavone@hotmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jun 18, 2021; 12(6): 433-444 Published online Jun 18, 2021. doi: 10.5312/wjo.v12.i6.433
Arthroereisis in juvenile flexible flatfoot: Which device should we implant? A systematic review of literature published in the last 5 years
Andrea Vescio, Gianluca Testa, Mirko Amico, Claudio Lizzio, Marco Sapienza, Piero Pavone, Vito Pavone
Andrea Vescio, Gianluca Testa, Mirko Amico, Claudio Lizzio, Marco Sapienza, Vito Pavone, Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, Catania 95123, Italy
Piero Pavone, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania 95123, Italy
Author contributions: All the authors contributed equally to this work.
Conflict-of-interest statement: The authors have no competing interests to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vito Pavone, MD, PhD, Associate Professor, Department of General Surgery and Medical Surgical Specialties, Section of Orthopedics and Traumatology, University Hospital Policlinico-San Marco, University of Catania, Via Santa Sofia, 78, Catania 95123, Italy. vitopavone@hotmail.com
Received: December 1, 2020 Peer-review started: December 1, 2020 First decision: February 15, 2021 Revised: March 21, 2021 Accepted: May 8, 2021 Article in press: May 8, 2021 Published online: June 18, 2021
ARTICLE HIGHLIGHTS
Research background
Flexible flatfoot (FFF) is a common disorder during childhood. When symptoms of early and easy fatigue during walking or pain are present, treatment is mandatory. Arthoereisis (AR) is frequently used for surgical management. Two device types were described, subtalar AR and calcaneo-stop (CS).
Research motivation
No common consensus or AR among orthopedic surgeons is present.
Research objectives
The aim of the study was to report the clinical and radiological outcomes after subtalar AR and CS procedures, including the results in obese and athlete populations, and the technique-related complications. Moreover, the intent was to include the more recent findings of the material devices.
Research methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to perform a systematic review of English-language articles published of the last 5 years.
Research results
Seventeen articles were included in the study after the initial screening and the risk of bias assessment. A total of 1864 FFFs were identified. Eight studies evaluated subtalar AR and nine evaluated CS (52.9%). At the start of treatment, the average age of patients was 11.8 years and the average study follow-up was 71.9 mo.
Research conclusions
Both AR procedures are valid surgical techniques for FFF treatment, surgeon experience, implant cost, and cosmetic correction were the most common considerations in the orthopedic decision-making process and AR choice. In obese patients, the subtalar AR is not recommended. In adolescents who need to improve sports performance, the CS screw had better results compared with other implants. In adolescents who need to improve sports performance, CS screws had a slightly lower rate of complications than subtalar self-locking implants.
Research perspectives
High-quality randomized clinical trials are needed.
