BIOMECHANICAL EFFECTS OF SURGICAL RECONSTRUCTION FOR FLEXIBLE ADULT ACQUIRED FLATFOOT DEFORMITY: A SYSTEMATIC REVIEW

Abstract

BACKGROUND The posterior tibial tendon functions to raise and restore the arch during gait. Degeneration of this tendon (PTTD) is the most common cause of AAFD. AAFD has four different stages which have different forms of treatment, ranging from bracing to surgical intervention. MATERIALS AND METHODS Systematic review that started with 605 articles on PubMed and ended with four. The four articles chosen involved patients with symptomatic flexible PTTD (stage 2 AAFD) who underwent reconstructive surgery. Additionally, surgical intervention includes osteotomies of the tarsals or metatarsals, tendon transfer, and/or ligament repair or reconstruction. Primary outcomes should involve objective quantifiable measurements of either kinematics, kinetics, or muscle activity. RESULTS In terms of overall biomechanics, surgical intervention for stage 2 adult acquired flatfoot deformity results in significant changes in objective, measurable biomechanical outcomes. Temporo-spatial, kinematic, and kinetic parameters were all altered after patients underwent surgical intervention. CONCLUSION Surgical intervention to treat stage II AAFD can improve biomechanical outcomes; however, more follow-up studies need to be done in order to more definitively conclude the biomechanical changes that result from surgical intervention for stage 2 AAFD.