Porous Titanium Wedges in Lateral Column Lengthening for Adult-Acquired Flatfoot Deformity

Area of Science:

• Orthopedic Surgery
• Podiatric Surgery
• Biomaterials Engineering

Background:

• Adult-acquired flatfoot deformity (AAFD) often requires surgical correction.
• Lateral column lengthening (LCL) is a key procedure for AAFD reconstruction.
• Porous titanium wedges offer a novel alternative to traditional bone grafts (allograft/autograft) in LCL.

Purpose of the Study:

• To evaluate the radiographic and clinical outcomes of using porous titanium wedges for LCL in AAFD patients.
• To assess the efficacy and safety of porous titanium wedges as a bone graft substitute.

Main Methods:

• Retrospective case series analysis of 34 feet in 30 patients undergoing LCL with porous titanium wedges.
• Data collected between January 2011 and October 2014.
• Radiographic assessment included lateral talo-first metatarsal angle, talonavicular uncoverage, first metatarsocuneiform height, and hindfoot valgus angle. Clinical follow-up ranged from 6 months to 4 years.

Main Results:

• Significant radiographic correction was observed in all measured parameters.
• No instances of nonunion or wedge migration were reported.
• The most frequent complication was calcaneocuboid joint pain (14.7%).

Conclusions:

• Porous titanium wedges are effective in achieving substantial radiographic and clinical correction for AAFD via LCL.
• This technique demonstrates a low rate of complications, including nonunion, making it a promising alternative to bone grafting.