Economic Impact of Congenital/Acquired Talotarsal Joint Dislocation and the Role of Extraosseous Talotarsal Stabilization

Daniel Hake, Peter Bregman


Musculoskeletal disorders are the leading cause of disability worldwide and the cost to treat these disorders continues to rise every year. The pain associated with muscular disorders results in decreased activity for those affected. Failure to properly treat musculoskeletal disorders can lead to the onset or exacerbation of existing secondary health-related diseases associated with decreased activity including diabetes, obesity, hypertension, heart disease, and osteoarthritis, which are also associated with increased healthcare costs. The foot, as the foundation of the body, must be properly aligned and/or balanced for the entire skeletal kinetic chain to function properly. Congenital/acquired talotarsal joint dislocation (TTJD) leads to an imbalance and misalignment of joints along the entire kinetic chain, ultimately leading to musculoskeletal disorders, pain, and comorbidities associated with a sedentary lifestyle. Conservative treatment of TTJD with orthotics is often ineffective due to poor patient compliance, and does not address the underlying cause of the pain associated with TTJD. Women are also less likely to use orthotics due to incompatibility with certain shoe styles. Invasive reconstructive surgery for the treatment of TTJD is associated with a risk of complications and a long recovery time. In contrast, extraosseous talotarsal stabilization is a minimally invasive procedure with few complications, and Type II implants have a removal rate of < 6%. Extraosseous talotarsal stabilization could serve as an important link in eliminating the underlying etiology of many chronic musculoskeletal deformities and, in the process, allow patients to maintain normal levels of activity to help combat the development of secondary health-related diseases associated with a sedentary lifestyle.


Chronic pain; extraosseous talotarsal stabilization; foot pain; musculoskeletal disorders; orthopedic surgery; talotarsal joint dislocation

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