Long-term results of tibialis anterior tendon transfer for relapsed idiopathic clubfoot treated with the Ponseti method: a follow-up of thirty-seven to fifty-five years

Joshua B Holt; David E Oji; H John Yack; Jose A Morcuende

doi:10.2106/JBJS.N.00525

Back

Long-term results of tibialis anterior tendon transfer for relapsed idiopathic clubfoot treated with the Ponseti method: a follow-up of thirty-seven to fifty-five years

Journal article

Peer reviewed

Long-term results of tibialis anterior tendon transfer for relapsed idiopathic clubfoot treated with the Ponseti method: a follow-up of thirty-seven to fifty-five years

Joshua B Holt, David E Oji, H John Yack and Jose A Morcuende

Journal of bone and joint surgery. American volume, Vol.97(1), pp.47-55

01/07/2015

DOI: 10.2106/JBJS.N.00525

PMID: 25568394

View Online

Abstract

Relapse of idiopathic clubfoot deformity after treatment can be effectively managed with repeat casting and tibialis anterior tendon transfer during early childhood. We evaluated the long-term effects on adult foot function after tibialis anterior tendon transfer for relapsed idiopathic clubfoot deformity during childhood. Thirty-five patients (sixty clubfeet) in whom idiopathic clubfoot was treated with the Ponseti method from 1950 to 1967 were followed. At an average age of forty-seven years (range, thirty-seven to fifty-five years), the patients underwent a detailed musculoskeletal examination, radiographic evaluation, pedobarographic analysis, and surface electromyography (EMG). They also completed three quality-of-life patient questionnaires. Fourteen patients (twenty-five clubfeet, 42%) had required repeat casting and tibialis anterior tendon transfer in childhood for relapsed clubfoot deformity after initial casting and served as the study group. Twenty-one patients (thirty-five clubfeet, 58%) were successfully treated with initial casting without relapse (the reference group). No patient in either group had subsequent relapse or required additional operative intervention associated with clubfoot deformity. The mean ankle dorsiflexion was similar between the groups. Radiographically, the tendon transfer group showed a smaller mean anteroposterior talocalcaneal angle and slightly more talar flattening than the reference group with no associated clinical differences. Peak pressures, total force distribution, and surface EMG results were not significantly different between the groups. Outcome questionnaires demonstrated no significant difference between the groups. Tibialis anterior tendon transfer is very effective at preventing additional relapse of deformity without affecting long-term foot function of patients with idiopathic clubfoot.

Recurrence

Follow-Up Studies

Humans

Middle Aged

Child, Preschool

Infant

Treatment Outcome

Clubfoot - diagnosis

Tendon Transfer

Treatment Failure

Quality of Life

Adult

Clubfoot - surgery

Retrospective Studies

Child

Casts, Surgical

Details

Title: Subtitle: Long-term results of tibialis anterior tendon transfer for relapsed idiopathic clubfoot treated with the Ponseti method: a follow-up of thirty-seven to fifty-five years
Creators: Joshua B Holt - Ponseti Clubfoot Treatment Center (J.B.H., D.E.O., and J.A.M.) and Orthopaedic Gait Analysis Laboratory (H.J.Y.), Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for J.B. Holt: joshua-holt@uiowa.edu
David E Oji - Ponseti Clubfoot Treatment Center (J.B.H., D.E.O., and J.A.M.) and Orthopaedic Gait Analysis Laboratory (H.J.Y.), Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for J.B. Holt: joshua-holt@uiowa.edu
H John Yack - Ponseti Clubfoot Treatment Center (J.B.H., D.E.O., and J.A.M.) and Orthopaedic Gait Analysis Laboratory (H.J.Y.), Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for J.B. Holt: joshua-holt@uiowa.edu
Jose A Morcuende - Ponseti Clubfoot Treatment Center (J.B.H., D.E.O., and J.A.M.) and Orthopaedic Gait Analysis Laboratory (H.J.Y.), Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for J.B. Holt: joshua-holt@uiowa.edu
Resource Type: Journal article
Publication Details: Journal of bone and joint surgery. American volume, Vol.97(1), pp.47-55
DOI: 10.2106/JBJS.N.00525
PMID: 25568394
NLM abbreviation: J Bone Joint Surg Am
ISSN: 0021-9355
eISSN: 1535-1386
Publisher: Journal of Bone and Joint Surgery Incorporated; United States
Language: English
Date published: 01/07/2015
Academic Unit: Stead Family Department of Pediatrics; Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science
Record Identifier: 9984040239102771

Metrics

10 Record Views

44 Times Cited - Web of Science