4/14/2011 8:41 AM
In a recent blog at PodiatryToday.com, Dr. Kevin Kirby reviewed the biomechanics of subtalar arthroresis. He did a thorough review of the literature, and in the blog discusses kinematic and kinetic functions of the subtalar joint, and the biomechanical effects of the subtalar arthroereisis procedure.
We recommend this article to anyone who performs STJ arthroresis or deals with patients who have undergone the procedure. You can read the article here.
The following is the conclusion to the article:
The modern STJ arthroereisis implant procedure has been in constant use for the surgical correction of flatfoot deformity in children and adults now for over 35 years, and is widely utilized for both the pediatric and adult flatfoot deformity. By acting as a “compression spacer” within the sinus tarsi and/or tarsal canal, the arthroereisis implant “resets” the maximally pronated STJ rotational position to a new, less pronated, postoperative STJ rotational position.
However, contrary to Vogler’s long-accepted arthroereisis implant classification scheme, all STJ arthroereisis implants are “direct impact” implants, which create compression forces between the talus and calcaneus that reduce STJ pronation. Additionally, all arthroereisis implants are “axis-altering” implants due to the change in STJ spatial location that occurs with resetting the maximally pronated STJ position to a new, more supinated postoperative rotational position.
Further scientific research and more long-term studies of arthroereisis implant patients will be necessary to better clarify both the positive and negative alterations in foot and lower extremity biomechanics that may occur from this relatively popular surgical procedure for the pathologic flatfoot deformity.