 Q: Do you remember that moment you decided to devote your life to the clubfoot treatment?
Dr P: I developed my clubfoot treatment technique through studying anatomy and biological studies of clubfoot in foetuses and newborns in the late 1940s and 1950s with cineradiography to understand better how the joints of the foot moved. We adopted this method because surgical intervention damaged the joints and ligaments and the feet became stiff, weak, and painful.
Q: Are you happy with your option today?
Dr P: Our treatment has been successful in the great majority of clubfeet we have treated. It is a very rewarding experience because if clubfeet are well treated they will function normally throughout life. The treatment is short and easy on the baby. Relapses can be avoided in most babies with faithful use of the foot abduction brace until the age of 3 years.
Q: What do you think about the doubts some doctors have about your method?
Dr P: The doubts doctors have about our technique are because most books and publications about clubfoot in the past century recommended surgery. This was because it was not realized that the ligaments in an infant are stretchable and the doctors do not understand the mechanics of the joints of the foot.
Q: Is your method better now than 50 years ago? What about the Ponseti Method in the future?
Dr P: For the past fifty years I have used the same basic technique since it is based on a proper understanding of the functional anatomy of the foot.
This will be the method of choice for the foreseeable future. Parents on the internet were a great influence in spreading word since they were able to tell other parents of clubfoot babies how easily the deformity can be corrected and that surgery is not necessary.
Q: Are you working to know more about clubfoot? Do you think someday parents will know about the clubfoot origin and prevent it?
Dr P: Genetic studies will be done to find out the cause of the clubfoot deformity. The prevention of the deformity is very far in the future.
I.V. Ponseti, M.D.
Iowa City, USA
Interview with Dr. Morcuende:
Q: How long do you work with the Ponseti Method? And why?
Dr M: I came to the States in 1991 because of my interests in research and the fact that this Department had a very strong research program, and I have been working here since then. Since my first day in the clinic, I saw the results of Dr. Ponseti method in patients with clubfoot and I was very impressed. It was such a dramatic difference for what I have learned in Spain! So, it was very easy for me to decide to use this method as the "Gold Standard" for the treatment of these patients.
Q: Why isn't the Method used all over the world?
Dr M: It is difficult to understand why the method has not been used in any other place than Iowa City. The first paper on clubfoot by Dr. Ponseti was published in 1963, and it was followed by a series of other papers. Why people did not "catch up" the importance of this work is really a mystery. However, many times in medicine, people make discoveries that take several years to be incorporated into the mainstream .... I think this is one of those cases.
Q: Do you know how many doctors work with this method, in the world?
Dr M: We do not know exactly how many doctors are now practicing the method. 4-5 years ago we can tell you that there was a handful number of them, just the ones trained here at Iowa. However, the "word" is spreading very fast and we hope that in the next 4-5 years, most paediatric orthopaedic surgeons will be practicing the method.
Q: How many kids do you treat every day?
Dr M: We see about 15-20 patients with clubfoot per week.
Q: What can we parents, expect from your work in the future?
Dr M: I think parents like you have made a great impact in clubfoot and are the most important factor in making a difference. There is no question in my mind about that! Thanks to your involvement and commitment, many families are now becoming familiar with the method and have the possibility to ask questions and bring their children to doctors trained in the method. But most importantly, it is my hope that many more families will continue participating in such a way and in the future any child born with clubfoot will have the chance to be treated with the Ponseti method.
Jose A. Morcuende, MD, PhD
Iowa City, USA
With courtesy of www.peboto.grupos.com.pt
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