title: Use of the arthroereisis screw with tendoscopic delivered platelet-rich plasma for early stage adult acquired flatfoot deformity.
abstract: Early stage adult acquired flatfoot deformity (AAFD) is traditionally treated with osteotomy and tendon transfer. Despite a high success rate, the long recovery time and associated morbidity are not sufficient. This study aims to evaluate the functional and radiological outcomes following the use of the arthroereisis screw with tendoscopic delivered PRP for early stage AAFD.
  
  
  
  Patients with stage IIa AAFD who underwent the use of the arthroereisis screw with tendoscopic delivered PRP with a minimum follow-up time of 24 months were retrospectively evaluated. Clinical outcomes for pain were evaluated with the Foot and Ankle Outcomes Score (FAOS) and Visual Analog Score (VAS). Radiographic deformity correction was assessed using weight-bearing imaging.
  
  
  
  Thirteen patients (13 feet) with mean follow-up of 29.5 months were included. The mean age was 37.3 years (range, 28-65 years). FAOS-reported symptoms, pain, daily activities, sports activities, and quality of life significantly improved from 52.1, 42.6, 57.6, 35.7, and 15.4 pre-operatively to 78.5, 68.2, 83.3, 65.0, and 49.6 post-operatively, respectively (p < 0.05). Statistically significant radiographic improvements (lateral talus first metatarsal angle, calcaneal pitch, and cuneiform to ground distance) were also observed between the pre- and post-operative images.
  
  
  
  This study elucidates the successful implementation of a less invasive approach to stage IIa AAFD. Through the use of a subtalar arthroereisis screw, PTT tendoscopy, and PRP injection, clinical and radiographic outcomes were improved.
authors.affiliation: Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan.|Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA.
authors.forename: Youichi
authors.initials: Y
authors.lastname: Yasui
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA.|Department of Orthopedic Surgery, Tokushima University, Tokushima, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tonogai
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Rosenbaum
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA.|Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: David M
authors.initials: DM
authors.lastname: Moore
authors.affiliation: Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Takao
authors.affiliation: Department of Orthopaedic Surgery, Teikyo University, Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kawano
authors.affiliation: Department of Foot and Ankle Surgery, Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY, 10021, USA. kennedyj@HSS.EDU.
authors.forename: John G
authors.initials: JG
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws / Q000009:adverse effects*; D004724:Endoscopy / Q000379:methods; D005260:Female; D005413:Flatfoot / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D053657:Platelet-Rich Plasma / Q000187:drug effects*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Acquired adult flatfoot deformity; Arthroereisis screw; Platelet rich plasma; Posterior tibial tendon dysfunction; Tendoscopy