0335T Insertion of sinus tarsi implant

Name of the Procedure:

Insertion of Sinus Tarsi Implant Also known as: Sinus Tarsi Arthroereisis

Summary

The insertion of a sinus tarsi implant is a minimally invasive surgical procedure designed to stabilize the foot and correct issues related to flatfoot deformity. It involves placing a small device, typically made of titanium or medical-grade plastic, into the sinus tarsi, a small canal in the foot, to support the arch.

Purpose

The procedure primarily addresses conditions like flatfoot deformity and excessive pronation. The goal is to restore proper foot alignment, improve function, and relieve pain associated with these conditions.

Indications

• Persistent flatfoot deformity that is unresponsive to conservative treatments (orthotics, physical therapy).
• Pain and discomfort due to overpronation.

• Pediatric flexible flatfoot, especially in children who are still growing.

  Preparation

• Pre-procedure fasting (usually from midnight before the surgery) if general anesthesia will be used.
• Stopping certain medications like blood thinners as advised by the doctor.
• Diagnostic tests including X-rays or MRI to assess the foot structure.

Procedure Description

1. Anesthesia: The patient is given regional or general anesthesia.
2. Incision: A small incision is made on the outer side of the foot.
3. Insertion: The implant is inserted into the sinus tarsi space.
4. Positioning: The implant is adjusted to achieve the correct alignment of the foot.

5. Closure: The incision is closed with sutures or surgical glue and dressed.

   Tools used include a guiding instrument for the implant and imaging tools for precise placement.

Duration

The procedure typically takes around 30 to 45 minutes.

Setting

This procedure is performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Orthopedic or podiatric surgeon
• Nurses
• Anesthesiologist

Risks and Complications

• Infection at the incision site
• Displacement of the implant
• Persistent pain or discomfort
• Allergic reactions to the implant material
• Rarely, nerve damage or improper foot alignment

Benefits

• Improved foot alignment
• Reduction in pain and discomfort
• Increased mobility and function
• Benefits can be often realized within a few weeks post-surgery, once initial swelling subsides.

Recovery

• Rest and limited weight-bearing on the affected foot for the first few days.
• Use of crutches or a walking boot as advised by the surgeon.
• Gradual return to normal activities over 4-6 weeks.
• Follow-up visits for monitoring and possible physical therapy.

Alternatives

• Custom orthotics and shoe modifications.
• Physical therapy to strengthen foot muscles.
• Other surgical options like osteotomy or tendon transfer.
• Pros: Non-surgical options have lower risk but might not be as effective in severe cases. Surgical alternatives might be more invasive but could provide more permanent correction.

Patient Experience

• During the procedure: Little to no sensation if under regional or general anesthesia.
• After the procedure: Mild to moderate pain and swelling, managed with prescribed pain medication and anti-inflammatories.
• Postoperative instructions include rest, elevation, and limited movement, with a monitored gradual return to normal activities.

By following the medical advice and post-procedure care instructions, most patients can expect a significant improvement in their condition.