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Stevens P, Lancaster A, Khwaja A. Talar-tarsal Stabilisation: Goals and Initial Outcomes. Strategies Trauma Limb Reconstr 2022; 16:168-171. [PMID: 35111256 PMCID: PMC8778731 DOI: 10.5005/jp-journals-10080-1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Peter Stevens
- Department of Orthopedics, University of Utah, Salt Lake City, Utah, United States of America
- Peter Stevens, Department of Orthopedics, University of Utah, Salt Lake City, Utah, United States, of America Phone: +801 330-3656, e-mail:
| | - Alex Lancaster
- Department of Orthopedics, University of Utah, Salt Lake City, Utah, United States of America
| | - Ansab Khwaja
- Department of Orthopedics, University of Arizona, Phoenix, Arizona, United States of America
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De Pellegrin M, Moharamzadeh D. Subtalar Arthroereisis for Surgical Treatment of Flexible Flatfoot. Foot Ankle Clin 2021; 26:765-805. [PMID: 34752238 DOI: 10.1016/j.fcl.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Various surgical techniques are known for the treatment of flexible flatfoot in children after failure of nonsurgical attempts. Data collected in a review of the last 10-year period (2010-2020) show that among the 691 feet undergoing subtalar arthroereisis with endorthesis, average age at surgery was 11.40 years and in the 1856 feet that underwent subtalar arthroereisis with calcaneo-stop 11.69 years, while the complications rate was 9.00% and 6.38%, respectively. These data confirm that subtalar arthroereisis with calcaneo-stop may have an advantage over subtalar arthroereisis with endorthesis as the screw is not placed across the subtalar joint but instead into the calcaneus.
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Affiliation(s)
- Maurizio De Pellegrin
- Pediatric Orthopedic and Traumatology Unit, San Raffaele Hospital, Via Olgettina 60, Milan 20132, Italy
| | - Désirée Moharamzadeh
- Orthopedic and Traumatology Unit, San Raffaele Hospital, Via Olgettina 60, Milan 20132, Italy.
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The outcomes of subtalar arthroereisis in pes planus: a systemic review and meta-analysis. Arch Orthop Trauma Surg 2021; 141:761-773. [PMID: 32377845 DOI: 10.1007/s00402-020-03458-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Subtalar arthroereisis has been increasingly accepted as a solution to manage symptomatic pes planus. However, despite the recent developments related to arthroereisis, no other published literature has aimed to review the outcomes in paediatric patients since 2010. This systematic review and meta-analysis, therefore, aims to evaluate the current outcomes of subtalar arthroereisis in the treatment of symptomatic pes planus among the paediatric population. MATERIALS AND METHODS The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All studies reported on the clinical outcomes of subtalar arthroereisis in children aged 21 or younger were included. RESULTS A total of 17 publications were included, with 1536 feet. The average duration of follow-up of the studies included in the review is 43.52 months. The studies consistently reported improvement in the radiological outcomes, approximating that of a normal population. Subtalar arthroereisis has shown to restore the collapsed medial longitudinal arch, supported by the decrease in Meary's angle to 5.267° (95% CI: 4.695°-5.839°, normal: 0°-10.0°) post-operatively and an increased calcaneal pitch of 15.70° (95% CI: 15.41°-15.99°, normal 18.0°-20.0°). Deformities associated with pes planus such as heel valgus was also significantly reduced, evident by the post-operative lateral talocalcaneal angle of 27.19° (95% CI: 26.44°-27.93°, normal: 25.0°-45.0°) and a post-operative Kite's angle of 18.13° (95% CI: 17.73°-18.52°, normal: 15.0°-30.0°). Subjectively, subtalar arthroereisis has generally resulted in an improvement in the grading of outcomes postoperatively from the patient's point of view. CONCLUSIONS Subtalar arthroereisis could serve as a procedure to correct radiological abnormalities, as well as relieve pain in selected patients with symptomatic pes planus.
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Suh DH, Park JH, Lee SH, Kim HJ, Park YH, Jang WY, Baek JH, Sung HJ, Choi GW. Lateral column lengthening versus subtalar arthroereisis for paediatric flatfeet: a systematic review. INTERNATIONAL ORTHOPAEDICS 2019; 43:1179-1192. [PMID: 30701302 DOI: 10.1007/s00264-019-04303-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/21/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE This systematic review aimed to compare radiographic correction, clinical outcomes, complications, and re-operations between lateral column lengthening (LCL) and arthroereisis (AR) for treating symptomatic flatfoot in children. METHODS We conducted a comprehensive search on MEDLINE, EMBASE, and Cochrane Library databases. Literature search, data extraction, and quality assessment were conducted by two independent reviewers. The outcomes analyzed included radiographic parameters, clinical scores, satisfaction, complications, and re-operations. RESULTS Twenty-one and 13 studies were included in the LCL and AR groups, respectively. The change in anteroposterior talo-first metatarsal angle was greater in the LCL (9.5° to 21.7°) than in the AR group (10.6° to 12.8°). The change in calcaneal pitch was greater in the LCL (2.1° to 26.53°) than in the AR group (- 1.3° to 3.23°). Improvements in the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were greater in the LCL (27.7 to 39.1) than in the AR group (17 to 22). The percentage of satisfaction was similar between the LCL (68% to 89%) and AR (78.5% to 96.4%) groups. The complication rate was higher in the LCL (0% to 86.9%) than in the AR group (3.5% to 45%). The most common complications were calcaneocuboid subluxation and persistent pain in the LCL and AR groups, respectively. The re-operation rate was similar between the LCL (0% to 27.3%) and AR (0% to 36.4%) groups. CONCLUSIONS The LCL group has achieved more radiographic corrections and more improvements in the AOFAS score than the AR group. Complications were more common in the LCL group than in the AR group, and the re-operation rates were similar between the two groups.
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Affiliation(s)
- Dong Hun Suh
- Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeonggi-do, 15355, South Korea
| | - Jung Ho Park
- Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeonggi-do, 15355, South Korea
| | - Soon Hyuck Lee
- Department of Orthopaedic Surgery, Korea University Anam Hospital, Seoul, South Korea
| | - Hak Jun Kim
- Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, South Korea
| | - Young Hwan Park
- Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, South Korea
| | - Woo Young Jang
- Department of Orthopaedic Surgery, Korea University Anam Hospital, Seoul, South Korea
| | - Jung Heum Baek
- Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeonggi-do, 15355, South Korea
| | - Hyun Jae Sung
- Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeonggi-do, 15355, South Korea
| | - Gi Won Choi
- Department of Orthopaedic Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-Gu, Ansan-si, Gyeonggi-do, 15355, South Korea.
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Wen J, Liu H, Xiao S, Li X, Fang K, Zeng M, Tang Z, Cao S, Li F. Comparison of mid-term efficacy of spastic flatfoot in ambulant children with cerebral palsy by 2 different methods. Medicine (Baltimore) 2017; 96:e7044. [PMID: 28562561 PMCID: PMC5459726 DOI: 10.1097/md.0000000000007044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/25/2017] [Accepted: 05/09/2017] [Indexed: 11/25/2022] Open
Abstract
To compare the treatment efficacy of spastic flatfoot surgery by 2 different surgical methods: nonfusion subtalar arthroereisis using subtalar joint stabilizer (SJS) and Dennyson-Fulford subtalar arthrodesis (D-FSA).A total of 26 cases of ambulant children with cerebral palsy diagnosed as spastic flatfoot were surgically treated from January 2011 to December 2014. Preoperative and postoperative American Orthopedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) scores, anteroposterior-talocalcaneal angles (ATAs), and lateral talar-first metatarsal angles (Meary angles) of the affected foot were recorded.Among 12 children in the SJS group, the AOFAS-AH scores were median preoperative score of 61 (58-64) versus median postoperative score of 83 (75-92), with significant difference (P < .05). Of the 20 feet treated, only 1 foot developed occasional pain. Postoperative ATA was decreased from preoperative 35° (20°-50°) to 19° (12°-25°); lateral X-ray films showed that the Meary angle was decreased from preoperative 20° (15°-40°) to postoperative 0° (0°-3°). The differences in both findings were statistically significant (P < .05). Fourteen children (22 treated feet) formed the D-FSA group; all demonstrated fusion of the talocalcaneal joint; AOFAS-AH scores were median preoperative score of 61 (58-64) versus median postoperative score of 83 (75-92), with significant difference (P < .05). Only 1 foot had occasional pain. Postoperative ATA was decreased from preoperative 35° (20°-45°) to 16° (12°-25°); lateral X-ray films showed that the Meary angle was decreased from preoperative 19° (10°-40°) to postoperative 2° (0°-5°); the differences in both findings were statistically significant (P < .05).Both nonfusion subtalar arthroereisis using SJS and D-FSA were effective for the surgical treatment of spastic flatfoot, with similar clinical outcomes.
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Nevalainen MT, Roedl JB, Zoga AC, Morrison WB. Imaging findings of arthroereisis in planovalgus feet. Radiol Case Rep 2016; 11:398-404. [PMID: 27920869 PMCID: PMC5128390 DOI: 10.1016/j.radcr.2016.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 08/21/2016] [Accepted: 08/22/2016] [Indexed: 11/17/2022] Open
Abstract
Arthroereisis is a rare and disputed procedure, where an implant screw is inserted into the sinus tarsi to treat flatfoot deformity. Weight-bearing radiographs are the most essential examinations to assess the correct localization and related measurements. Hardware loosening is the most common complication seen as localized lucency and as dislocation of the implant. Computed tomography yields superior resolution with reconstruction capabilities. On magnetic resonance imaging, the implant appears as a dark signal focus on T1 and T2-weighted images with a hyperintense T2-signal rim. As the data on the imaging of arthroereisis are scarce, we aimed here to review the typical imaging findings.
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Affiliation(s)
- Mika T. Nevalainen
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Thomas Jefferson University Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, 132 South 10th St, Philadelphia, PA 19107, USA
- Department of Radiology, Central Finland Central Hospital, Keskussairaalantie 19, Jyväskylä 40620, Finland
| | - Johannes B. Roedl
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Thomas Jefferson University Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, 132 South 10th St, Philadelphia, PA 19107, USA
| | - Adam C. Zoga
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Thomas Jefferson University Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, 132 South 10th St, Philadelphia, PA 19107, USA
| | - William B. Morrison
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Thomas Jefferson University Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, 132 South 10th St, Philadelphia, PA 19107, USA
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Arthroereisis: physiologic blocking of the subtalar joint. CURRENT ORTHOPAEDIC PRACTICE 2016. [DOI: 10.1097/bco.0000000000000418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jay RM, Din N. Correcting pediatric flatfoot with subtalar arthroereisis and gastrocnemius recession: a retrospective study. Foot Ankle Spec 2013; 6:101-7. [PMID: 23263679 DOI: 10.1177/1938640012470714] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Flatfoot deformities are common in children and are treated using many conservative and surgical approaches. Subtalar extra-articular arthroereisis, in particular, limits talar motion, spares the subtalar joint, and prevents excessive subtalar joint pronation. Addressing the underlying equinus deformity with gastrocnemius recession is an important factor in optimizing outcomes in patients with flatfoot deformity. METHODS This study included 20 children, 4 to 17 years old. The patients presented 34 cases of functional flexible flatfoot, and each was treated with gastrocnemius recession and a subtalar implant insertion of either a resorbable arthroereisis plug constructed of poly-L lactic acid or a threaded titanium alloy plug. Clinical evaluation was based on the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale as well as subjective assessments of pain, function, shoe wear, and overall preoperative and postoperative satisfaction. RESULTS The average AOFAS Ankle-Hindfoot Scale reading improved by 21.3 points (standard deviation = 8.1; 95% confidence interval = 17.5-25.1), from an average preoperative reading of 67.7 points to an average postoperative reading of 89 points (P < .0001). Subjectively, patients experienced reduced pain and improved function, cosmesis, and shoe wear. CONCLUSIONS Treating equinus deformity with gastrocnemius recession significantly improved patient outcomes when treating flatfoot deformity. Reconstructive flatfoot surgery that combined subtalar arthroereisis with a resorbable arthroereisis plug and gastrocnemius recession resulted in favorable clinical outcomes and patient satisfaction. Symptom improvement and preservation of the subtalar joint were seen with these procedures, which are reasonable and useful options in treating children with symptomatic flexible flatfoot. LEVELS OF EVIDENCE Therapeutic, Level IV, Retrospective case series.
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Yen-Douangmala D, Vartivarian M, Choung JD. Subtalar arthroereisis and its role in pediatric and adult population. Clin Podiatr Med Surg 2012; 29:383-90. [PMID: 22727379 DOI: 10.1016/j.cpm.2012.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Subtalar joint arthroereisis is a surgical procedure that addresses symptomatic flexible flatfoot deformities using an extraarticular implant within the sinus tarsi. Three groups of implants have been developed for this procedure: self-locking wedges, axis-altering devices, and impact-blocking devices. The self-locking wedge implants are the focus of this article, relative to its use, limitations, and controversies in the pediatric and adult population.
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Affiliation(s)
- Daphne Yen-Douangmala
- Department of Podiatric Surgery, Kaiser Foundation Hospital, 99 Montecillo Road, San Rafael, CA 94903, USA
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Metcalfe SA, Bowling FL, Reeves ND. Subtalar joint arthroereisis in the management of pediatric flexible flatfoot: a critical review of the literature. Foot Ankle Int 2011; 32:1127-39. [PMID: 22381197 DOI: 10.3113/fai.2011.1127] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Pediatric flexible flatfoot is a common deformity for which a small, but significant number undergo corrective surgery. Arthroereisis is a technique for treating flexible flatfoot by means of inserting a prosthesis into the sinus tarsi. The procedure divides opinion in respect of both its effectiveness and safety. METHODS A database search up until 2010 was used to find articles regarding arthroereisis in pediatric patients. We summarized the findings of this study. RESULTS Seventy-six studies were identified. Eight of the nine radiographic parameters reported show significant improvement following arthroereisis reflecting both increased static arch height and joint congruency. Calcaneal inclination angle demonstrated the least change with only small increases following arthroereisis. Arthroereisis remains associated with a number of complications including sinus tarsi pain, device extrusion, and under-correction. Complication rates range between 4.8% and 18.6% with unplanned removal rates between 7.1% and 19.3% across all device types. CONCLUSION Current evidence is limited to consecutive case series or ad hoc case reports. Limited evidence exists to suggest that devices may have a more complex mode of action than simple motion blocking or axis altering effects. The interplay between osseous alignment and dynamic stability within the foot may contribute to the effectiveness of this procedure. Although literature suggests patient satisfaction rates of between 79% to 100%, qualitative outcome data based on disease specific, validated outcome tools may improve current evidence and permit comparison of future study data.
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Affiliation(s)
- Stuart A Metcalfe
- Manchester Metropolitan University, Institute for Biomedical Research into Human Movement and Health, Manchester, M1 5GD, UK.
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Corpuz M, Shofler D, Labovitz J, Hodor L, Yu K. Fracture of the talus as a complication of subtalar arthroereisis. J Foot Ankle Surg 2011; 51:91-4. [PMID: 21962334 DOI: 10.1053/j.jfas.2011.08.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Indexed: 02/03/2023]
Abstract
Subtalar joint arthroereisis remains a popular procedure for a flexible flatfoot deformity. Potential complications of the procedure have been discussed in published reports and are often believed to have resulted from shortcomings related to the mechanical properties of the biomaterial, implant size, and/or implant placement. In the present report, we describe the case of a talar neck fracture with migration of the implant after subtalar joint arthroereisis performed 10 years earlier. The 19-year-old patient was treated with implant removal and open reduction internal fixation and bone void filler and recovered unremarkably thereafter.
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Affiliation(s)
- Michael Corpuz
- Western University of Health Sciences College of Podiatric Medicine, Pomona, CA 91766, USA
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van Ooij B, Vos CJS, Saouti R. Arthroereisis of the subtalar joint: an uncommon complication and literature review. J Foot Ankle Surg 2011; 51:114-7. [PMID: 21956005 DOI: 10.1053/j.jfas.2011.08.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Indexed: 02/03/2023]
Abstract
Arthroereisis is an operation to prevent abnormal pronation in the subtalar joint in children and adults with symptomatic flexible flatfeet. In the present report, we describe an uncommon late complication of a former variation of this procedure, namely the case of an adult male who experienced migration of a xenogeneic bone graft that had been implanted 55 years earlier. A thorough review of the existing data was also undertaken to better understand the complications of this procedure.
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Affiliation(s)
- Bas van Ooij
- Department of Orthopaedic Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
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Abstract
Arthroereisis has gained popularity over the years because it eliminates excessive pronation while conserving preoperative inversion and preserves forefoot to rearfoot adaptation to uneven terain. Technically simple, some of the advantages of subtalar arthroereisis are that it is joint sparing and preserves ligaments. In addition, the implant does not interfere with osseous growth and does not compromise future operative intervention if more invasive procedures are required. Arthroereisis, however, can have associated complications along with the need for surgical removal in some patient populations.
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Didomenico LA, Haro AA, Cross DJ. Double calcaneal osteotomy using single, dual-function screw fixation technique. J Foot Ankle Surg 2011; 50:773-5. [PMID: 21737314 DOI: 10.1053/j.jfas.2011.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 05/12/2011] [Indexed: 02/03/2023]
Abstract
Historically, a variety of fixation techniques for calcaneal osteotomies have been used. The prevention of postoperative sequelae, including delayed or nonunion of the osteotomy sites and minimization of soft tissue damage, is always a primary consideration for foot and ankle surgeons. The present report describes a fixation technique for a double calcaneal osteotomy that entails use of a single screw that functions as both a positional tool, as well as a compressive fixation device. This technique provides compressive and positional qualities and decreases the amount of soft tissue disruption to the surgical site.
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Affiliation(s)
- Lawrence A Didomenico
- Department of Podiatry, Department of Surgery, St. Elizabeth Health Center, Youngstown, OH, USA.
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Cook EA, Cook JJ, Basile P. Identifying risk factors in subtalar arthroereisis explantation: a propensity-matched analysis. J Foot Ankle Surg 2011; 50:395-401. [PMID: 21708340 DOI: 10.1053/j.jfas.2011.03.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Indexed: 02/03/2023]
Abstract
A case-control study was undertaken to identify differences in patients with flexible flatfoot deformity who required explantation of subtalar arthroereisis compared with those who did not. All patients who required removal of a self-locking wedge-type subtalar arthroereisis were identified between 2002 and 2008. Propensity scores matched 22 explanted subtalar arthroereises to 44 controls (nonexplanted arthroereises), resulting in a total of 66 implants that met all inclusion and exclusion criteria. Multivariate logistic regression found that patients who required explantation had a greater odds of radiographic undercorrection, determined from radiographic anteroposterior talar-first metatarsal angles postoperatively, P = .0012, odds ratio (OR) = 1.175 (95% confidence interval [CI] 1.066 to 1.295), or residual transverse plane-dominant deformities, as determined from radiographic calcaneocuboid abduction angles postoperatively, P = .05, OR = 1.096 (95% CI 1.06 to 1.203). Patients with smaller postoperative anteroposterior talocalcaneal angles had a 16.7% reduction in odds for arthroereisis explantation (P = .0019) (95% CI 6.5% to 25.8%). Age, gender, implant size, shape, duration, implant position, surgeon experience, and concomitant procedures were not statistically different between the 2 groups. This study helps identify key factors that may result in subtalar arthroereisis explantation.
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Affiliation(s)
- Emily A Cook
- Harvard Medical School, Beth Israel Deaconess Medical Center, Division of Podiatric Surgery, Department of Surgery, Boston, MA 02215, USA
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