CPT® Code 0511T

1. Indications

The sinus tarsi implant procedure is indicated for patients experiencing conditions related to hyper-pronation of the foot, specifically:

• Flexible Flatfoot A condition characterized by excessive pronation of the foot, leading to instability and discomfort.
• Mobile Flatfoot A variant of flatfoot where the arch appears normal when not bearing weight but collapses under load, causing misalignment of the talus over the calcaneus.
• Excessive Pain or Discomfort Patients may require removal of the implant if they experience significant pain or discomfort in the foot or ankle, indicating a need for surgical intervention.

2. Procedure

The procedure for the removal and reinsertion of a sinus tarsi implant involves several critical steps:

• Step 1: Incision and Exposure The surgical process begins with an incision made on the lateral side of the hindfoot, directly over the sinus tarsi. This incision allows access to the channel where the implant is located. The surgeon carefully debrides the area to remove any scar tissue that may obstruct visibility and access to the implant.
• Step 2: Removal of the Implant Once the implant is exposed, the surgeon uses forceps or a clamp to grasp the implant securely. The implant is then carefully removed from the channel, ensuring minimal trauma to the surrounding tissues. After removal, the incision is closed, and the procedure may transition to reinsertion if indicated.
• Step 3: Reinsertion of the Implant To reinsert the implant, a blunt lever is introduced through the sinus tarsi and positioned under the neck of the talus bone. The lever is advanced distally, which facilitates the supination of the hindfoot while simultaneously pronating the forefoot. This maneuver helps to reposition the talus head into its correct anatomical location, effectively correcting the hindfoot pronation.
• Step 4: Trial Implants and Final Placement During the procedure, trial implants may be introduced to determine the appropriate size for the patient. Intraoperative imaging may be utilized, along with simulated weight bearing, to ensure correct placement and the desired degree of correction before the final implant is placed.

3. Post-Procedure

Post-procedure care involves monitoring the surgical site for signs of infection and ensuring proper healing of the incision. Patients may be advised on weight-bearing restrictions and rehabilitation exercises to promote recovery and restore function. Follow-up appointments are essential to assess the positioning of the implant and the overall recovery process. Any concerns regarding pain or discomfort should be addressed promptly to ensure optimal outcomes.