Arthroereisis Implant for the Treatment of Flexible Flatfoot Conditions
DESCRIPTION
The arthroereisis implant is an "internal orthotic" designed to correct flexible flatfoot conditions in pediatric and adult individuals. Flatfoot (i.e., pes planus or pes planovalgus) is a common deformity with the individual's foot having an abnormal flatness of the sole and the arch of the foot. The term “flexible” means that while the foot is flat when standing (weight-bearing), the arch returns when not standing.
POLICY
Arthroereisis implant for the treatment of flexible flatfoot is considered investigational.
ADDITIONAL INFORMATION
Available studies found have not sought to evaluate the clinical importance of the data generated by arthroereisis implants for flatfeet.
SOURCES
Adelman, V., Szczepanski, J., & Adelman, R. (2008). Radiographic evaluation of endoscopic gastrocnemius recession, subtalar joint arthroereisis, and flexor tendon transfer for surgical correction of stage II posterior tibial tendon dysfunction: a pilot study. Journal of Foot and Ankle Surgery, 47 (5), 400 - 408. (Level 5 Evidence)
BlueCross BlueShield Association. Medical Policy Reference Manual. (8:2009). Subtalar arthroereisis (7.01.104). Retrieved December 22, 2009 from BlueWeb. (9 articles and/or guidelines reviewed).
Complete guide to Medicare Coverage Issues [Computer software]. (2009, July). Foot Care (NCD 290, p. 4-276). The Ingenix Complete Guide to Medicare Coverage Issues.
Dockery, G. L., & Crawford, M. E. (1999). The Maxwell-Brancheau arthroereisis (MBA) implant in pediatric and adult flexible flatfoot conditions. Foot and Ankle Quarterly, 12 (4), 107-120. (Level 5 Evidence)
National Guideline Clearinghouse. Guideline Index. American College of Foot and Ankle Surgeons. (2005, April). Diagnosis and treatment of adult flatfoot. Retrieved January 14, 2010 from http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=6827&string=adult+AND+flat+AND+foot.
Scher, D., Bansal, M., Handler-Matasar, S., Bohne, W., & Green, D. (2007). Extensive implant reaction in failed subtalar joint arthroereisis: report of two cases. HSS Journal, 3 (2), 177 - 181. (Level 5 Evidence)
U. S. Food and Drug Administration. (2001, August). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K960692. Retrieved January 14, 2010 from http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=109613.
U. S. Food and Drug Administration. (2001, August). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K071456. Retrieved January 14, 2010 fromhttp://www.accessdata.fda.gov/cdrh_docs/pdf7/K071456.pdf.
U. S. Food and Drug Administration. (2006, April). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K053543. Retrieved January 14, 2010 from http://www.accessdata.fda.gov/cdrh_docs/pdf5/K053543.pdf.
ORIGINAL EFFECTIVE DATE: 4/13/2006
MOST RECENT REVIEW DATE: 2/11/2010
ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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