Clinical orthopaedics and related research | 2016 | Miller NH, Carry PM, Mark BJ, Engelman GH
Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.
[Indexed for MEDLINE] 20. BMC Musculoskelet Disord. 2026 May 28. doi: 10.1186/s12891-026-10032-7. Online ahead of print. Contemporary national treatment patterns for clubfoot relapse-related interventions: a large multi-institutional cohort. Hamad CD(1), Wiener J(1)(2)(3), Liu T(1), Golzar A(4), Dajani AJ(4), Kaelber DC(3), Bernthal NM(1), Sheppard WL(1), Baghdadi S(5)(6), Silva M(1)(7). Author information: (1)Department of Orthopaedic Surgery, University of California, 1225 15th Street - Suite 3144B Santa Monica, Los Angeles, CA, 90404, USA. (2)Case Western Reserve University School of Medicine, Cleveland, OH, USA. (3)Population and Quantitative Health Sciences, Case Western Reserve University and the Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH, USA. (4)David Geffen School of Medicine, University of California, Los Angeles, CA, USA. (5)Department of Orthopaedic Surgery, University of California, 1225 15th Street - Suite 3144B Santa Monica, Los Angeles, CA, 90404, USA. SBaghdadi@mednet.ucla.edu. (6)Luskin Orthopaedic Institute for Children, Los Angeles, CA, USA. SBaghdadi@mednet.ucla.edu. (7)Luskin Orthopaedic Institute for Children, Los Angeles, CA, USA. BACKGROUND: While the Ponseti method is the gold standard for treatment of congenital clubfoot, recurrence after initial correction remains common. Most published data describing management of recurrent deformity are derived from single center series, and national practice patterns are not well defined. The purpose of this study was to characterize contemporary utilization of interventions used as proxies for clubfoot recurrence in a large multi-institutional database. MATERIALS AND METHODS: We conducted a retrospective descriptive study using the TriNetX Research Network. Children diagnosed with idiopathic clubfoot at one year of age or younger were identified and followed longitudinally for up to seven years after an index ambulatory visit. Relapse related interventions were defined using CPT codes and included repeat casting, repeat Achilles tenotomy, tibialis anterior tendon transfer, and bony osteotomies. Kaplan Meier analyses were used to estimate the cumulative probability of remaining free from each intervention over time. RESULTS: The final cohort included 4,522 children with early diagnosed idiopathic clubfoot and longitudinal follow up. Any relapse-related intervention occurred in 23.11% of children, with repeat casting being the most common (16.08%). Tibialis anterior tendon transfer was performed in 6.23% and repeat Achilles tenotomy in 5.75% of eligible patients. Bony procedures were uncommon, with calcaneal osteotomy performed in 0.75%, tarsal osteotomy in 1.64%, and first metatarsal osteotomy in 0.27% of children. Kaplan Meier estimates demonstrated that casting and tendon procedures occurred earlier in childhood, whereas osteotomies were rare late interventions with procedural free survival exceeding 97% at seven years. CONCLUSIONS: In this large national cohort of children with idiopathic clubfoot, procedure-based interventions consistent with recurrence occurred in approximately one-quarter of patients, with repeat casting representing the predominant management strategy. Tendon procedures were used selectively, and bony procedures were rare, reinforcing their role as salvage interventions for rigid or multiply recurrent deformities. These population level data provide contemporary benchmarks for counseling families, guiding expectations, and informing future research on recurrence management following Ponseti treatment. © 2026. The Author(s). DOI: 10.1186/s12891-026-10032-7
This article has not been linked to a wiki topic yet.
This article has not been linked to a case yet.
This article has not been linked to an atlas yet.
