Systematic Review/Meta-Analysis On Arthroereisis In Pediatric Symptomatic Flexible Flat Foot

Abstract

rthroereisis is a newly proposed surgical technique to treat pediatric symptomatic flexible flat foot, attempting to avoid fusion procedures and osteotomies. The goal hereby is providing a quantitative and qualitative assessment of different techniques of arthroereisis procedures done alone/or with tendo-achilles lengthening in symptomatic flexible flat foot in children with minimum follow-up of twelve months and identification of the underlying common complications encountered and their likelihood of occurrences after reviewing the existing studies. Arthroereisis procedure is a simple and reliable surgery for treatment of pediatric symptomatic flexible flat foot with very low complications rates. Either it’s been done alone or with tendo-achilles lengthening/gastrocnemius recession, this procedure yields a high potential of restoring the medial longitudinal arch of the foot and eliminating the symptoms and signs found in the flexible flat foot patients. Patients start weight-bearing same day of surgery with no need for a splint if the procedure has been done alone with no accompanying bony procedures. The procedure improves the quality of life for children and daily activities if it has been done in an early stage. Several complications have been reported in the literature, the most common of them are implant breakage/loosening and under-correction. Both of the complications have very low rate of occurrence. Implant breakage/loosing is treated by removal, under-correction is treated by implant replacement. The only deficiency that should be highlighted is the lack of strong evidence in the literature regarding when to operate, specific implant types to be used, the clinical and functional outcomes should be included in most of the upcoming studies to assist in decision making and patient selection for the operation.