Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons · 2026
Accelerated versus standard ponseti method for idiopathic clubfoot: A systematic review and meta-analysis of efficacy and safety.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Llombart-Blanco Rafael, Mariscal Gonzalo, Altabbaa Hashem, Polevoi Egor, Barrios Carlos, Llombart-Ais Rafael
Аннотация
BACKGROUND: The Ponseti method is the gold standard for managing congenital idiopathic clubfoot. Recent modifications, such as the accelerated Ponseti protocol, aim to shorten treatment duration without compromising outcomes. However, evidence comparing its efficacy and safety to the standard protocol remains inconclusive.
OBJECTIVE: To compare the efficacy and safety of the accelerated versus standard Ponseti method in the treatment of congenital idiopathic clubfoot.
METHODS: Eligible studies included randomized controlled trials and prospective comparative studies involving patients with idiopathic clubfoot treated with either accelerated or standard Ponseti methods.
RESULTS: Sixteen studies involving 957 patients were included. There was no significant difference between groups in post-treatment Pirani score [MD = -0.03, 95 % CI (-0.24-0.17), p = 0.75], tenotomy rate [RR = 1.04, 95 % CI (0.99-1.09), p = 0.14], or relapse rate [RR = 1.11, 95 % CI (0.80-1.55), p = 0.54]. However, the accelerated group required slightly more casts [MD = 0.38, p = 0.032] but achieved significantly shorter treatment duration [MD = -20.43 days, p < 0.001]. Subgroup and sensitivity analyses confirmed the robustness of the findings. No major methodological flaws were detected, though blinding was generally lacking.
CONCLUSION: The accelerated Ponseti method is as effective and safe as the standard protocol, with the advantage of significantly shorter treatment duration. It may be a preferable alternative in appropriate clinical settings, though standardized implementation and long-term follow-up are recommended.
OBJECTIVE: To compare the efficacy and safety of the accelerated versus standard Ponseti method in the treatment of congenital idiopathic clubfoot.
METHODS: Eligible studies included randomized controlled trials and prospective comparative studies involving patients with idiopathic clubfoot treated with either accelerated or standard Ponseti methods.
RESULTS: Sixteen studies involving 957 patients were included. There was no significant difference between groups in post-treatment Pirani score [MD = -0.03, 95 % CI (-0.24-0.17), p = 0.75], tenotomy rate [RR = 1.04, 95 % CI (0.99-1.09), p = 0.14], or relapse rate [RR = 1.11, 95 % CI (0.80-1.55), p = 0.54]. However, the accelerated group required slightly more casts [MD = 0.38, p = 0.032] but achieved significantly shorter treatment duration [MD = -20.43 days, p < 0.001]. Subgroup and sensitivity analyses confirmed the robustness of the findings. No major methodological flaws were detected, though blinding was generally lacking.
CONCLUSION: The accelerated Ponseti method is as effective and safe as the standard protocol, with the advantage of significantly shorter treatment duration. It may be a preferable alternative in appropriate clinical settings, though standardized implementation and long-term follow-up are recommended.