Kite Versus Ponseti Method in the Treatment of Idiopathic Congenital Clubfoot: A Systematic Review and Meta-Analysis

Area of Science:

• Orthopedics
• Pediatric Surgery
• Medical Research

Background:

• Idiopathic congenital clubfoot is a common congenital foot deformity.
• The Kite and Ponseti methods are established manipulative techniques for clubfoot correction.
• Comparative efficacy data between these two methods are crucial for clinical decision-making.

Purpose of the Study:

• To compare the effectiveness of the Ponseti method versus the Kite method in treating idiopathic congenital clubfoot in children.
• To evaluate primary outcomes including initial correction rates and relapse rates.
• To assess secondary outcomes such as the number of casts required and the overall duration of treatment.

Main Methods:

• A systematic literature search was conducted across major databases (Medline/PubMed, Cochrane, Web of Science, Scopus, ProQuest) up to May 1, 2024.
• Meta-analysis was performed on data from nine included studies.
• Risk Ratios (RR) and Mean Differences (MD) with 95% Confidence Intervals (CIs) were calculated for dichotomous and numerical outcomes, respectively.

Main Results:

• The Ponseti method showed a significantly higher probability of initial correction (RR = 1.23) and a lower risk of relapse (RR = 0.50) compared to the Kite method.
• Treatment with the Ponseti method required fewer casts (MD = -3.0) and a shorter overall duration (MD = -39.76 days).
• Statistical significance was achieved for all primary and secondary outcomes (p < 0.05).

Conclusions:

• The Ponseti method is more effective than the Kite method for idiopathic congenital clubfoot, yielding better correction rates and reduced relapse.
• The Ponseti method offers advantages in terms of treatment efficiency, requiring fewer casts and less time.
• Further research is warranted to address the identified risks of bias and limitations in follow-up duration in existing studies.