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Bass RZ. A Lesser Recognized Coalition to Add to the Search Pattern: An Anatomy Review and Clinical Implications of Cubonavicular Coalition. Acad Radiol 2024; 31:857-858. [PMID: 38365494 DOI: 10.1016/j.acra.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 02/03/2024] [Indexed: 02/18/2024]
Affiliation(s)
- Rachel Zimmerman Bass
- University of Alabama at Birmingham, Department of Radiology, 619 19th St S, JTN 304, Birmingham, Alabama 35249, USA.
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Polt M, Graf DA, Brunner S, Helmy N, Tondelli T, Karczewski D, Andronic O. Outcomes of surgical management for tarsal coalitions: a systematic review. Arch Orthop Trauma Surg 2023; 143:6993-7008. [PMID: 37462747 DOI: 10.1007/s00402-023-04982-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/02/2023] [Indexed: 11/11/2023]
Abstract
PURPOSE To analyze the outcome of surgical treatment of tarsal coalition, assess the role of the surgical technique, as well as of coalition size and type on outcomes. METHODS The search followed the Preferred Reporting Items of Systematic Review and Meta-Analysis and was performed in four databases: MEDLINE, Central, Scopus and Web of Science. The protocol has been registered in the international prospective register of systematic reviews. Patient-reported outcomes (PROMs), complications, revisions and radiographic recurrence were collected. Risk of bias was assessed using MINORS criteria. A random-effects model for meta-analysis was applied for analysis of data heterogeneity. RESULTS Twenty-five studies including 760 tarsal coalitions were included and had a weighted average follow-up of 44 months. Studies scored fair to poor on the risk of bias assessment with a mean MINORS score of 67% (44-81%). In 77.8% (37.5-100%) of surgically treated tarsal coalitions, good/excellent/non-limiting or improved PROMs were reported. Calculated data heterogeneity was moderate (I2 = 57%). Open bar resection with material interposition had a clinical success rate of 78.8% (50-100%). Complications occurred in 4.96% of cases. Coalition size did not prove to be a determining factor in postoperative outcome. The influence of the coalition type was not investigated by any of the studies. CONCLUSION Data on outcomes of surgical management for tarsal coalitions is limited to retrospective case series with high risk of bias and moderate data heterogeneity. In about ¾ of cases, open resection and interposition of material results in improved PROMs. The arbitrary margin of ≥ 50% of TC coalition size in relation to the posterior facet has little importance in surgical decision-making. None of the studies reported on the influence of the coalition type on postoperative clinical success.
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Affiliation(s)
- Maksym Polt
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland.
| | - David Alexander Graf
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
| | - Samuel Brunner
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
| | - Naeder Helmy
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
| | - Timo Tondelli
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
| | - Daniel Karczewski
- Department of Trauma and Orthopaedics, Charitè University Medicine Berlin, Center for Musculoskeletal Surgery, Charitéplatz 1, 10117, Berlin, Germany
| | - Octavian Andronic
- Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland
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Hollander JJ, Dusoswa QF, Dahmen J, Sullivan N, Kerkhoffs GMMJ, Stufkens SAS. 8 out of 10 patients do well after surgery for tarsal coalitions: A systematic review on 1284 coalitions. Foot Ankle Surg 2022; 28:1110-1119. [PMID: 35397990 DOI: 10.1016/j.fas.2022.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND The primary aim was to determine the clinical success rate after treatment for talocalcaneal (TCC) and calcaneonavicular coalitions (CNC). The secondary aim was to evaluate the complication, recurrence and revision rate. METHODS A search was carried out in MEDLINE, EMBASE and Cochrane Library. Methodological quality was assessed using the Methodological Index for Non-Randomised Studies (MINORS) criteria. The primary outcome was the clinical success rate and was pooled per type of coalition and treatment modality. 95% Confidence Intervals (CI) of the success rates were calculated. Secondary outcomes included complication rates, coalition recurrence rates, revision rates and pain improvement using the Visual Analogue Scale (VAS). A sub-analysis on interposition material was performed. RESULTS 43 articles comprising of 1284 coalitions were included, with a pooled mean follow-up of 51 months. Methodological quality was fair. The overall pooled success rate for TCCs was 79% (95% CI, 75%-83%). Conservative treatment, open resection and arthroscopic resection of TCCs resulted in success rates of 58% (95% CI, 42%-73%), 80% (95% CI, 76%-84%) and 86% (95% CI, 71%-94%), respectively. CNCs have an overall success rate of 81% (95% CI, 75%-85%), with 100% (95% CI, 34%-100%), 80% (95% CI, 74%-85%) and 100% (95% CI, 65%-100%) for conservative treatment, open resection and arthroscopic resection, respectively. Pooled complication rates of 4% (95% CI, 3%-7%) for TCCs and 6% (95% CI, 4%-11%) for CNCs were found. The success rates of resection with and without interposition material for TCCs were 83% (95% CI, 78%-87%) and 79% (95% CI, 65%-88%), and for CNCs 81% (95% CI, 76%-86%) and 69% (95% CI, 44%-85%), respectively. CONCLUSION Treatment of tarsal coalitions can be considered good to excellent as well as safe, with an overall clinical success rate of 79% for TCCs and 81% for CNCs. Arthroscopic resection of the coalition appears to be non-inferior to open resection of TCCs and CNCs. LEVEL OF EVIDENCE Level IV, Systematic Review.
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Affiliation(s)
- Julian J Hollander
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Academic Center for Evidence based Sports medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Quinten F Dusoswa
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Academic Center for Evidence based Sports medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jari Dahmen
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Academic Center for Evidence based Sports medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nicholas Sullivan
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Academic Center for Evidence based Sports medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sjoerd A S Stufkens
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Academic Center for Evidence based Sports medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands.
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