Our Summary

This research paper discusses a surgical method called arthroscopic subtalar fusion. This procedure is typically used to treat issues with the subtalar joint (the joint just below the ankle) when more traditional non-surgical treatments have not worked. The paper outlines when this procedure should be used, how it is performed, advice for surgeons, and potential complications. The authors suggest that this surgical approach can yield great results, including a quicker recovery and return to normal activities and sports. However, it is not suitable for all cases, such as those with severe misalignment or bone loss.

FAQs

  1. What is arthroscopic subtalar fusion and when is it indicated?
  2. What are some potential complications of the posterior arthroscopic approach to subtalar fusion?
  3. What are the reported benefits of arthroscopic subtalar fusion, including recovery and rehabilitation times?

Doctor’s Tip

One helpful tip a doctor might tell a patient about joint fusion is to follow post-operative rehabilitation and physical therapy protocols closely to ensure successful fusion and optimal recovery. It is important to keep the joint immobilized and protected during the initial healing period, while gradually increasing range of motion and weight-bearing as directed by your healthcare provider. Sticking to these guidelines can help promote proper fusion and improve overall outcomes.

Suitable For

Patients who are typically recommended joint fusion include those with severe subtalar pathologic conditions that have not responded to conservative treatment, such as arthritis, severe pain, instability, and deformity. Patients with excessive malalignment and bone loss may not be suitable candidates for joint fusion. The arthroscopic subtalar fusion approach is recommended for patients who are looking for a faster recovery time and improved function after surgery.

Timeline

Before joint fusion:

  • Patient experiences pain, swelling, and limited mobility in the affected joint
  • Patient undergoes conservative treatments such as physical therapy, medication, and injections to manage symptoms
  • If conservative treatments are ineffective, patient and healthcare provider discuss the option of joint fusion surgery
  • Pre-operative assessments and preparations are made including imaging studies and medical clearance

After joint fusion:

  • Patient undergoes arthroscopic subtalar fusion surgery using a posterior approach
  • Post-operatively, patient is immobilized in a cast or boot to allow for proper healing of the fused joint
  • Physical therapy and rehabilitation begin to help improve strength and mobility in the affected joint
  • Patient gradually resumes daily activities and may eventually return to sports or other physical activities
  • Long-term follow-up appointments are scheduled to monitor the success of the fusion and address any complications or concerns.

What to Ask Your Doctor

  1. What are the potential risks and complications of joint fusion surgery?
  2. How long is the recovery process after joint fusion surgery?
  3. Will I need physical therapy after the surgery?
  4. How soon can I expect to see improvement in my joint pain and function?
  5. Are there any alternative treatments to joint fusion that I should consider?
  6. Will I need any assistive devices, such as a walker or cane, after the surgery?
  7. What type of anesthesia will be used during the surgery?
  8. How long will the fusion take to fully heal?
  9. Will I be able to return to my normal activities, such as sports, after the fusion surgery?
  10. What type of follow-up care will I need after the surgery?

Reference

Authors: Wagner E, Melo R. Journal: Foot Ankle Clin. 2018 Sep;23(3):475-483. doi: 10.1016/j.fcl.2018.04.007. PMID: 30097086