Subtalar Arthroereisis for Posterior Tibial Tendon Dysfunction: A Preliminary Report

Abstract

Background: The purpose of this study was to evaluate preliminary results with Kalix® subtalar arthroereisis in sinus tarsi for stage II posterior tibial tendon dysfunction. Methods: Twenty-one patients with stage II posterior tibial dysfunction, according to Johnson and Storm, underwent surgical treatment between July 1999 and December 2000. All patients were evaluated clinically using the America Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle score. We performed a tendon repair depending on the type and location of the injury and implanted a Kalix® endorthesis in the sinus tarsi. Results: Nineteen patients attended for clinical review with an average follow-up of 27.31 months (range, 19–36). AOFAS scale improved from a preoperative average of 47.2 to an average of 81.6 at revision. The most important improvement was observed in pain (16.3 preoperative to 31.6 postoperative). Two cases required removal of the endorthesis for pain, probably because the endorthesis was too big, without any loss of correction. Patient satisfaction was “satisfied” or “very satisfied” in 17/19. All except three patients would have elected to undergo the same procedure. Conclusions: Subtalar arthroereisis by means of implantation of a Kalix® endorthesis in the sinus tarsi, with prior correction of the deformity and tendon repair, offers an alternative to bone operations such as calcaneal osteotomies, lengthening the external column, or arthodesis in patients with stage II posterior tibial dysfunction.