Regenerative Medicine: Re-Growing Body Parts
MAKOplasty Robotic Knee Surgery
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New Flat Foot Surgery
Although flat foot is on the rise, a new surgery developed at Hospital for Special Surgery (HSS) can improve outcomes in those with severe adult flat foot deformity. Patients who undergo the new surgery have better long-term outcome and mobility than those who undergo traditional surgery.
“Before this study, we were not sure whether you could salvage patients with flat foot and ankle deformity and correct their ankle as well as their foot deformity,” said Jonathan Deland, M.D., Chief of the Department of Foot and Ankle Surgery at Hospital for Special Surgery, in the news release. “Now we know that with this technique you can save the ankle, and it provides a correction of the deformity even at nine years after surgery.” Dr. Deland developed the surgery and is senior author of the study.
If the deformity is severe and symptomatic enough, then surgeons either perform an ankle replacement or, more commonly, fuse the ankle. “The fusion is not ideal because it takes all the motion away in the ankle in a patient who already has a foot problem,” said Scott Ellis, M.D., in the news release. A foot and ankle orthopedic surgeon at HSS, Dr. Ellis added, “Imagine walking without motion in your ankle. It changes your gait and it leads to arthritis in the other joints of the foot over time, eight to ten years down the line, because you start having to use those joints to take up the slack of motion that is not occurring in the ankle.”
In the new surgery, surgeons not only reconstruct the flat foot deformity, but they also reconstruct the deltoid ligament using a tendon that runs along the outside of the calf called the peroneus longus. A person can function without their peroneus longus. Alternatively, the peroneus longus can be kept and a cadaver tendon used.
HSS investigators conducted the new surgery in five patients, four men and one woman, and monitored the surgery’s success. Patients underwent X-rays that showed the surgery improved the alignment in the ankle and the effects were long-lasting.
As for why we are seeing a rise in flatfoot, Dr. Deland told OTW,
Flat feet and stage IV flat feet (ankle joint) are becoming more commonly recognized by physicians, and the treatment options are better understood. Furthermore, the average weight of Americans is increasing, therefore increasing the incidence of the condition.
He also commented to OTW,
Deltoid ligament reconstruction was formerly an unsolved problem. No one had published a longer term series of results to date. Consequences for the untreated condition are serious progressive arthritis in the ankle joint.