CAVUS FOOT – CAUSES AND TREATMENTS

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years

Disclaimer:

This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.
 

Image Credit: Cambridge.org 

“Take care of yourself, be healthy, and always believe you can be successful in anything you truly want.” Alessandra Ambrosio

There are a multitude of foot and ankle conditions that are induced by conditions such as physical activity or wearing the incorrect shoe size. These conditions are induced by external influences on the feet. Internal influences caused by conditions such as diabetes, or other neurologically induced conditions are also responsible for foot conditions developing with time. One such condition is known as Cavus Foot – identified by the feet developing really high arches. 

What Is Cavus Foot?  

Identified as a medical condition which results in the feet having a very high arch, Cavus foot is a condition that causes a weight distribution problem in the feet. The center of gravity of the body is affected, and an excessive amount of weight is experienced on the ball and the heel of the feet during physical activity. As a condition that can develop at any age, Cavus Foot is definitely one of those conditions that can be induced with internal changes. Cavus foot can develop in either one or both of the feet. With the severity of the arch, will be the severity of the symptoms experienced by the patient.

In some individuals for instance, the high arch will cause a pressure differential that will cause extra pressure on the ball and heel of the feet. This causes discomfort on the feet and the change in centre of gravity can lead to conditions such as foot and ankle sprains. In other individuals, the gait and the manner in which individuals normally walk will be changed. Individuals can end up walking on what is defined as the exterior of the foot. With various root causes, the appropriate treatment of cavus foot will be determined by your foot and ankle specialist. With treatments ranging from foot supports to surgery, it is possible to treat and heal this condition.

Causes of Cavus Foot 

Medical statistics have indicated that Cavus foot is predominantly caused by neurologically based conditions. The conditions that can induce Cavus Foot include: 

  • Palsy 
  • Charcot-Marie-Tooth disease
  • Spina bifida
  • Polio
  • Muscular dystrophy
  • Stroke 

Via a consultation with your Orthopaedic specialist, the root cause of the condition will be identified. Knowing the underlying cause of the condition will determine how best to treat the condition. It will be important to treat the neurologic disorder, as well as to treat the deformity of the feet. With the two fold based treatment, it will be possible to keep the condition under control. 

Symptoms

The predominant determinant of the Cavus foot condition is the high arch that is developed as a result of the condition. In terms of the overall condition, there are a few symptoms that have been identified as belonging to Cavus foot. These include: 

  • Hammertoes (bent toes) 
  • Calluses (located on the  ball, side or heel of the foot)
  • Painful motion when standing or walking
  • A shift in the center of gravity causing unstable feet. The heel  will be tilting inward, instead of being vertical in a healthy person, which can lead to ankle sprains that are recurrent.
  • Foot drop, a weakness in the foot and ankle muscles. This may cause the patient to drag their feet when walking. When foot drop is experienced, this is an indicator of an underlying neurologic condition. 

Diagnosis

During a consultation with your Orthopaedic surgeon, the diagnosis of Cavus foot can then take place. Your doctor will initially begin with a review of your family history. After this, a foot and ankle examination will take place. Typically, during these examinations, the external symptoms such as the high arch, calluses, hammertoes etc, will be looked at. Utilizing additional tools such as X-rays and MRI imagery, a feel for the internal condition of the feet can then be assessed.

Your Orthopaedic surgeon will also take the time to check the strength of the feet, note your current walking pattern and other general observations pertaining to your gait. The wear and tear on your shoes will also be examined as well. If there are further neurologic tests to be completed, you will be referred to a neurologist who will then conduct a further neurologic examination.

Nonsurgical Treatment

In the instance of non-surgical treatments, patients may be treated via treatments such as: 

  • Orthotic devices. Custom orthotic devices that fit into the shoe can be beneficial because they provide stability and cushioning to the foot.
  • Shoe modifications. High-topped shoes support the ankle, and shoes with heels a little wider on the bottom add stability.
  • Bracing. The surgeon may recommend a brace to help keep the foot and ankle stable. Bracing is also useful in managing foot drop.[1] 

When Is Surgery Needed?

In the worst case scenario, when non-surgical treatments are not correcting the problem, then surgery will be the next best alternative. The surgical procedures taken by your orthopaedic specialist will be able to relieve the symptoms, facilitate restoration of the joint and enable its integrity to be restored. The surgical procedures utilized may be multiple, and phased across a series of months in order to facilitate a full treatment. 

References: 

  1. Cavus Foot: https://www.foothealthfacts.org/conditions/cavus-foot-(high-arched-foot)
  2. Cavus Foot: https://www.chop.edu/conditions-diseases/cavus-foot#:~:text=Cavus%20foot%20is%20a%20condition,the%20condition%20is%20causing%20pain.

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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