Nitinol Compression Staples in Foot Orthopaedic Surgery: A Systematic Review

Area of Science:

• Orthopaedic Surgery
• Biomaterials Science
• Clinical Outcomes Research

Background:

• Nitinol compression staples offer advantages in foot and ankle surgery, including ease of use and favorable biomechanics.
• Limited data exists comparing nitinol staples to traditional implants like plates and screws in this surgical area.

Purpose of the Study:

• To systematically review and describe the clinical outcomes of nitinol staple use in forefoot and midfoot orthopaedic surgery.

Main Methods:

• A comprehensive literature search was performed across PubMed, Web of Science, and Embase.
• Studies focusing on clinical outcomes of nitinol staples in foot surgery were included; biomechanical studies and hindfoot procedures were excluded.
• Two independent reviewers screened titles, abstracts, and full texts to ensure adherence to inclusion criteria.

Main Results:

• Nine articles met the inclusion criteria, with studies focusing on forefoot, midfoot, or combined regions.
• Significant improvements were observed in visual analog scale pain scores, Ankle Osteoarthritis Scale scores, and Foot and Ankle Ability Measure activities of daily living scores.
• The overall fusion rate was 94.6%, with a complication rate of 11.25% across studies reporting union.

Conclusions:

• Nitinol staples, used alone or with other constructs, demonstrate an acceptable fusion rate in foot surgery.
• Currently, there is a scarcity of clinical data directly comparing nitinol staples to traditional surgical implants.
• The existing literature exhibits heterogeneity regarding nitinol staple configurations and designs, necessitating further standardization and research.