Our Summary

This research paper discusses the advancements in foot and ankle surgery, particularly focusing on the procedure known as subtalar joint arthrodesis which can now be performed arthroscopically, i.e., using a tiny camera and small instruments. This method is believed to have several benefits, including higher success rates, fewer complications, less discomfort during and after the surgery, and a faster recovery time.

However, this method might not be suitable for more complex deformities or when other open surgical procedures are required. The researchers describe the specific surgical techniques used in this method and present the results and potential complications based on a detailed review of existing research. They considered thirteen past studies of moderate quality.

The results showed that this method has a high success rate with 96% of surgeries resulting in successful fusion of the joint, with the average time for the union being just over 8 weeks. The overall complication rate was 21%, with the most common issues being metal irritation, nerve injury, and infection.

The success and complication rates were similar when comparing this method to traditional open surgery, except for infection risk which might be lower with arthroscopy. The researchers found no evidence suggesting that using bone grafts or more than one screw improved the outcomes. They concluded that there isn’t enough evidence to definitively say that arthroscopic subtalar fusion is superior to open techniques.

FAQs

  1. What are the potential advantages of arthroscopic subtalar joint arthrodesis?
  2. What are the common complications associated with arthroscopic subtalar joint arthrodesis?
  3. How does the success rate of arthroscopic subtalar fusion compare to open techniques?

Doctor’s Tip

A helpful tip a doctor might tell a patient about joint fusion is to follow post-operative instructions closely, including keeping weight off the joint as directed, attending all follow-up appointments, and diligently participating in physical therapy to aid in the healing process and ensure successful fusion. Additionally, maintaining a healthy lifestyle, including proper nutrition and exercise, can help promote optimal healing and long-term joint health.

Suitable For

Patients who are typically recommended joint fusion include those with severe arthritis in the subtalar joint, chronic pain and instability in the joint, deformities that cannot be corrected with conservative measures, and failed previous attempts at conservative treatment. Those who are relatively young and active may also be good candidates for joint fusion in order to maintain function and reduce pain in the affected joint.

Timeline

Before the joint fusion procedure, a patient may experience pain, swelling, stiffness, and limited range of motion in the affected joint. They may have tried conservative treatments such as medication, physical therapy, and injections without success. The patient would undergo preoperative evaluation and imaging studies to assess the joint condition and determine if fusion is the best treatment option.

After the joint fusion procedure, the patient will typically experience postoperative pain, swelling, and stiffness. They will be instructed to keep weight off the fused joint and use assistive devices such as crutches or a walker. Physical therapy will be prescribed to help regain strength and range of motion in the surrounding joints. Over time, the fused joint will heal, and the patient will gradually return to normal activities with improved stability and pain relief. Follow-up appointments will be scheduled to monitor the fusion site and ensure proper healing.

What to Ask Your Doctor

  1. What are the potential benefits of undergoing arthroscopic subtalar joint arthrodesis compared to traditional open surgery?
  2. What is the success rate of arthroscopic subtalar joint arthrodesis in terms of achieving fusion?
  3. How long does it typically take for the joint to fully fuse after arthroscopic subtalar joint arthrodesis?
  4. What are the most common complications associated with arthroscopic subtalar joint arthrodesis?
  5. Are there any specific factors that may make me a better candidate for arthroscopic subtalar joint arthrodesis versus open surgery?
  6. How experienced are you in performing arthroscopic subtalar joint arthrodesis procedures?
  7. How long is the recovery time after undergoing arthroscopic subtalar joint arthrodesis?
  8. Are there any specific post-operative precautions or exercises I should be aware of after the procedure?
  9. What are the potential long-term outcomes or complications to consider after undergoing arthroscopic subtalar joint arthrodesis?
  10. Are there any alternative treatment options that may be considered before proceeding with arthroscopic subtalar joint arthrodesis?

Reference

Authors: Oshba H, Shaaban RHA, Abdelrahman I, Gougoulias N. Journal: Foot Ankle Int. 2022 Jan;43(1):131-145. doi: 10.1177/10711007211035397. Epub 2021 Sep 22. PMID: 34549616