The effectiveness of the Ponseti method for treating clubfoot associated with arthrogryposis: up to 8 years follow-up.

PURPOSE To evaluate the effectiveness of the Ponseti method in treating clubfoot associated with arthrogryposis. METHODS Retrospective consecutive review over a 10-year period in a tertiary centre of all patients with arthrogrypotic clubfoot treated with the Ponseti method. The primary outcome measure at final follow-up was the functional correction of the deformity. RESULTS There were ten children with 17 arthrogrypotic clubfeet, with an average follow-up of 5.8 years (range 3-8 years). The average age at presentation was 5 weeks (range 2-20 weeks). Deformities were severe, with an average Pirani score of 5.5 (range 3-6). Initial correction was achieved in all children with an average of 8 (range 4-10) Ponseti casts and a tendo-Achilles tenotomy (TAT) was performed in 94.1 %. Two-thirds of patients had a satisfactory outcome at final follow-up, with functional plantigrade, pain-free feet. CONCLUSIONS The Ponseti method is an effective first-line treatment for arthrogrypotic clubfeet to achieve functional plantigrade feet. Children will often require more casts and have a higher risk of relapse.