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  • Title: A biomechanical model of the effect of subtalar arthroereisis on the adult flexible flat foot.
    Author: Arangio GA, Reinert KL, Salathe EP.
    Journal: Clin Biomech (Bristol, Avon); 2004 Oct; 19(8):847-52. PubMed ID: 15342157.
    Abstract:
    OBJECTIVE: The hypothesis tested was that the increased load on the medial arch in the adult flat foot can be reduced through a 6 mm subtalar arthroereisis. DESIGN: A three-dimensional multisegment biomechanical model was used in conjunction with experimental data and data from the literature. BACKGROUND: Biomechanical models have been used to study the plantar fascia, medial arch height, subtalar motion, medial displacement calcaneal osteotomy and distribution of forces in the foot. METHODS: Responses of a normal foot, a flat foot, and a flat foot with a subtalar arthroereisis to an applied load of 683 N were analyzed and the distribution of support among the metatarsal heads and the moment about various joints were computed. RESULTS: The flattened foot results in an increase in the load on the head of the first metatarsal from 10% to 24% of the body weight, and an increase in the moment about the talo-navicular joint from 3.4 to 11.9 Nm. Insertion of a 6 mm cylinder into the sinus tarsi, subtalar arthroereisis, results in a shift of the load back toward the lateral column, decreasing the load on the first metatarsal to 6% of the body weight and decreasing the moment about the talo-navicular joint to 6.0 Nm. CONCLUSIONS: Our analysis indicates that a 6 mm subtalar arthroereisis in an adult flat foot model decreases the load on the medial arch.
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