Publication Name	World Journal of Meta-Analysis
Manuscript ID	118716
Country	Pakistan

Category	Orthopedics
Manuscript Type	Meta-Analysis
Article Title	Paradigm shift in clubfoot care strategies in Pakistan: A meta-analysis over three decades
Manuscript Source	Invited Manuscript
All Author List	Anisuddin Bhatti, Saddam Mazar Baloch, Jose Antonio Morcuende, Kiran Jaffri and Muhammad Yousuf Bhatti
Funding Agency and Grant Number
Corresponding Author	Saddam Mazar Baloch, Assistant Professor, Consultant, MD, Orthopaedic and Spine Surgery, Dr Ziauddin Hospital Clifton, 4/B Shahrah-e-Ghalib Rd, Block 6 Clifton, Karachi 75600, Sindh, Pakistan. drmazar@gmail.com
Key Words	Clubfoot; Orthopaedic procedures; Surgery; Conservative treatment; Pakistan; Treatment outcome; Congenital abnormalities; Health services accessibility; Paediatrics; Ponseti method
Core Tip	This meta-analysis synthesizes 35 years of clubfoot management literature from Pakistan, documenting a complete paradigm shift from predominantly surgical approaches (pre-2005) to the Ponseti method as the dominant strategy (96% adoption by 2025). Pooled short-term success reached 87.2% (approaching global benchmarks of 90%-95%), with referral age declining to 6.3 months, highlighting the impact of national training programs. However, very short follow-up (mean 1.8 years) represents a major limitation, as global evidence shows relapse rates rise significantly after age 4-5 years, emphasizing the need for long-term studies to confirm durable correction in resource-limited settings.
Citation	Bhatti A, Mazar Baloch S, Morcuende JA, Jaffri K, Bhatti MY. Paradigm shift in clubfoot care strategies in Pakistan: A meta-analysis over three decades. World J Meta-Anal 2026; In press

Received	2026-01-09 03:44
Peer-Review Started	2026-01-09 03:44
First Decision by Editorial Office Director	2026-02-14 07:26
Return for Revision	2026-02-15 04:41
Revised	2026-02-24 17:59
Publication Fee Transferred
Second Decision by Editor	2026-05-20 02:38
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-05-20 09:53
Articles in Press	2026-05-20 09:53
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2308-3840 (online)
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