Severe equinus cavo-varus correction through triplanar tarsectomy and posterior tibial tendon transfer based on 3D-printed biomodel.

The research article presents a study on the effectiveness of a surgical procedure, triplanar tarsectomy combined with posterior tibial tendon transfer, in treating severe equinus cavo-varus foot deformity, based on personalized 3D biomodel planning. The procedure showed promising results in improvements in terms of patient function and satisfaction.

Study Overview and Objectives

• The procedure investigated in this study is a surgical treatment for a complex deformity of the foot known as severe equinus cavo-varus. Given the significant variability in this condition across individuals, the researchers used personalized 3D biomodels to plan each surgery.
• The primary aim of this study was to assess the effectiveness and patient satisfaction of this surgical approach in a small group of patients with severe equinus cavo-varus deformity.

Participants and Procedure

• The study analyzed the outcomes of 12 surgeries performed on 5 patients, of which two were females and five were males. Each patient’s condition was monitored over a median period of 38.5 months.
• The surgical procedure involved triplanar tarsectomy, which is the surgical removal of some bones in the foot, and transposition of the posterior tibial tendon that is relocation of the tendon in the calf that supports the arch of the foot — all planned based on a patient-specific 3D biomodel.

Measurements and Findings

• The researchers used the Foot and Ankle Disability Index (FADI) to measure function and disability before and after surgery. There was a marked improvement in FADI scores post-surgery, indicating improved function and reduced disability.
• The main variable assessed was the attainment of a stable, plantigrade foot (one that can be placed flat on the ground). This was achieved in all but one patient, who had a residual equinus (extension) of 5º.
• The significant difference in pre- and post-surgery FADI scores and achieving plantigrade foot in most patients suggested that the combination of triplanar tarsectomy and posterior tibial tendon transfer, based on patient-specific 3D biomodel planning, is a viable approach for treating severe equinus cavo-varus deformity.