What’s arthroeresis?

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Arthroereisis is a surgical procedure that is done to intentionally impair motion in a joint. It involves implanting a small piece of hard material inside a joint to prevent excessive joint flexion or collapse. The procedure is most commonly done to treat flat feet in adults who have suffered from the condition for several years without finding relief from other treatments. Since arthroeresis surgery is a relatively new procedure, there is some uncertainty among professionals regarding its usefulness and safety. Ongoing research and long-term clinical trials will help doctors and their patients make smarter decisions about considering joint surgery.

Flat feet arise when the arch and instep in the midfoot are too flexible: The subtalar joint responsible for maintaining the structure of the foot collapses when weight bearing on the foot. The subtalar joint connects the talus bone at the bottom of the ankle to the calcaneus at the heel and instep. Physical therapy and anti-inflammatory medications are usually sufficient to manage flatfoot symptoms, but persistent problems may require surgery. A surgeon may try to tighten the supporting tendons or perform arthroereisis.

Before an arthroresis procedure, an anesthetist or podiatrist administers a local anesthetic to the foot. A small incision is made at the base of the talus bone and clamps are used to hold the skin and cartilage laterally. With the subtalar joint exposed, excess cartilage tissue can be removed to create space for the implant. Most surgeons use hard plastic implants because they are durable and less likely to cause adverse allergic reactions in patients. The implant is screwed or compressed into the joint and the surgical wound is closed and treated.

After surgery, a patient typically needs to wear a cast or brace for at least two weeks to give the joint time to heal. When the brace is removed, a podiatrist carefully examines the foot and takes x-rays to make sure the arthroeresis has been successful. Patients generally need to rest for several weeks and then begin light physical therapy exercises to rebuild strength. Osteoarthritis is occasionally performed on both feet simultaneously, but in most cases, surgeons prefer to wait several months between procedures to ensure good results and avoid compromising the patient’s mobility completely.

There are significant risks with osteoarthritis surgery, and many doctors are reluctant to suggest the procedure due to inconclusive evidence of its safety. Implants change the way joints are used to moving, and some patients develop severe foot pain after a few months or years. In such cases, the implants must be surgically removed and other treatment options considered. People who are considering surgery are encouraged to research the procedure thoroughly and talk to several doctors before making any decisions.

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