TY - JOUR
T1 - 8 out of 10 patients do well after surgery for tarsal coalitions
T2 - A systematic review on 1284 coalitions
AU - Hollander, Julian J.
AU - Dusoswa, Quinten F.
AU - Dahmen, Jari
AU - Sullivan, Nicholas
AU - Kerkhoffs, Gino M. M. J.
AU - Stufkens, Sjoerd A. S.
N1 - Funding Information: The authors would like to thank AMC's clinical librarian, F.S. van Etten-Jamaludin, for her work in the present systematic review and J.P.M. van Oosterhout for her assistance with drafting the manuscript. All authors report no conflict of interest. Not applicable. Publisher Copyright: © 2022 The Authors
PY - 2022/10
Y1 - 2022/10
N2 - Background: The primary aim was to determine the clinical success rate after treatment for talocalcaneal (TCC) and calcaneonavicular coalitions (CNC). The secondary aim was to evaluate the complication, recurrence and revision rate. Methods: A search was carried out in MEDLINE, EMBASE and Cochrane Library. Methodological quality was assessed using the Methodological Index for Non-Randomised Studies (MINORS) criteria. The primary outcome was the clinical success rate and was pooled per type of coalition and treatment modality. 95% Confidence Intervals (CI) of the success rates were calculated. Secondary outcomes included complication rates, coalition recurrence rates, revision rates and pain improvement using the Visual Analogue Scale (VAS). A sub-analysis on interposition material was performed. Results: 43 articles comprising of 1284 coalitions were included, with a pooled mean follow-up of 51 months. Methodological quality was fair. The overall pooled success rate for TCCs was 79% (95% CI, 75%−83%). Conservative treatment, open resection and arthroscopic resection of TCCs resulted in success rates of 58% (95% CI, 42%−73%), 80% (95% CI, 76%−84%) and 86% (95% CI, 71%−94%), respectively. CNCs have an overall success rate of 81% (95% CI, 75%−85%), with 100% (95% CI, 34%−100%), 80% (95% CI, 74%−85%) and 100% (95% CI, 65%−100%) for conservative treatment, open resection and arthroscopic resection, respectively. Pooled complication rates of 4% (95% CI, 3%−7%) for TCCs and 6% (95% CI, 4%−11%) for CNCs were found. The success rates of resection with and without interposition material for TCCs were 83% (95% CI, 78%−87%) and 79% (95% CI, 65%−88%), and for CNCs 81% (95% CI, 76%−86%) and 69% (95% CI, 44%−85%), respectively. Conclusion: Treatment of tarsal coalitions can be considered good to excellent as well as safe, with an overall clinical success rate of 79% for TCCs and 81% for CNCs. Arthroscopic resection of the coalition appears to be non-inferior to open resection of TCCs and CNCs. Level of evidence: Level IV, Systematic Review.
AB - Background: The primary aim was to determine the clinical success rate after treatment for talocalcaneal (TCC) and calcaneonavicular coalitions (CNC). The secondary aim was to evaluate the complication, recurrence and revision rate. Methods: A search was carried out in MEDLINE, EMBASE and Cochrane Library. Methodological quality was assessed using the Methodological Index for Non-Randomised Studies (MINORS) criteria. The primary outcome was the clinical success rate and was pooled per type of coalition and treatment modality. 95% Confidence Intervals (CI) of the success rates were calculated. Secondary outcomes included complication rates, coalition recurrence rates, revision rates and pain improvement using the Visual Analogue Scale (VAS). A sub-analysis on interposition material was performed. Results: 43 articles comprising of 1284 coalitions were included, with a pooled mean follow-up of 51 months. Methodological quality was fair. The overall pooled success rate for TCCs was 79% (95% CI, 75%−83%). Conservative treatment, open resection and arthroscopic resection of TCCs resulted in success rates of 58% (95% CI, 42%−73%), 80% (95% CI, 76%−84%) and 86% (95% CI, 71%−94%), respectively. CNCs have an overall success rate of 81% (95% CI, 75%−85%), with 100% (95% CI, 34%−100%), 80% (95% CI, 74%−85%) and 100% (95% CI, 65%−100%) for conservative treatment, open resection and arthroscopic resection, respectively. Pooled complication rates of 4% (95% CI, 3%−7%) for TCCs and 6% (95% CI, 4%−11%) for CNCs were found. The success rates of resection with and without interposition material for TCCs were 83% (95% CI, 78%−87%) and 79% (95% CI, 65%−88%), and for CNCs 81% (95% CI, 76%−86%) and 69% (95% CI, 44%−85%), respectively. Conclusion: Treatment of tarsal coalitions can be considered good to excellent as well as safe, with an overall clinical success rate of 79% for TCCs and 81% for CNCs. Arthroscopic resection of the coalition appears to be non-inferior to open resection of TCCs and CNCs. Level of evidence: Level IV, Systematic Review.
KW - Arthroscopy
KW - Calcaneonavicular coalition
KW - Conservative
KW - Resection
KW - Talocalcaneal coalition
KW - Tarsal coalition
UR - http://www.scopus.com/inward/record.url?scp=85127675678&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.fas.2022.03.011
DO - https://doi.org/10.1016/j.fas.2022.03.011
M3 - Review article
C2 - 35397990
SN - 1268-7731
VL - 28
SP - 1110
EP - 1119
JO - Foot and Ankle Surgery
JF - Foot and Ankle Surgery
IS - 7
ER -