Our Summary

This research paper discusses a type of foot surgery called posterior arthroscopic subtalar joint arthrodesis (PASTA). The study found that PASTA is a good alternative to the standard approach for this surgery. It has several advantages including better healing of the wound, better control of pain, and better healing of the bone. PASTA also doesn’t harm the nerves or blood vessels in the foot as much as the standard procedure. Patients who have had certain types of foot surgery in the past might benefit more from PASTA if they need another procedure in the future. The paper provides detailed information about how to perform the PASTA surgery.

FAQs

  1. What are the benefits of the arthroscopic approach compared to open procedures in terms of postoperative course?
  2. What is posterior arthroscopic subtalar joint arthrodesis (PASTA) and how does it compare to standard lateral-portal subtalar joint arthrodesis?
  3. Who are the patients that may benefit more from PASTA over open arthrodesis if STJ fusion becomes necessary?

Doctor’s Tip

One helpful tip a doctor might tell a patient about joint fusion is to follow the prescribed rehabilitation plan diligently. This may include physical therapy exercises to help improve range of motion, strength, and stability in the fused joint. It is important to adhere to the recommended activity restrictions and gradually increase activity levels as advised by the healthcare provider to optimize the outcome of the joint fusion procedure.

Suitable For

Patients who are typically recommended joint fusion include those with severe arthritis, joint deformity, chronic instability, or joint damage that has not responded to conservative treatments such as physical therapy, medications, or injections. Patients who have undergone previous failed joint replacement surgery or fusion procedures may also be candidates for joint fusion. Additionally, patients with certain conditions such as rheumatoid arthritis, severe trauma, or congenital deformities may benefit from joint fusion to improve joint function and reduce pain.

Timeline

Before joint fusion:

  1. Initial consultation with a healthcare provider to address pain and limitations in joint function.
  2. Diagnostic imaging, such as X-rays or MRI, to assess the extent of joint damage.
  3. Discussion of treatment options, including joint fusion, with the healthcare provider.
  4. Preoperative preparation, which may include blood tests, medication adjustments, and instructions for postoperative care.

After joint fusion:

  1. Surgery to fuse the joint, which may be done arthroscopically or through an open procedure.
  2. Postoperative recovery period, which includes pain management, wound care, and physical therapy.
  3. Follow-up appointments with the healthcare provider to monitor healing progress and address any complications.
  4. Rehabilitation exercises to improve joint strength and range of motion.
  5. Gradual return to normal activities, with ongoing monitoring of joint function and pain levels.

What to Ask Your Doctor

  1. What is the reason for recommending joint fusion in my case?
  2. What are the potential risks and complications associated with joint fusion surgery?
  3. What is the expected recovery time and rehabilitation process after joint fusion surgery?
  4. Will I be able to return to my normal activities, including sports, after joint fusion surgery?
  5. Are there any alternative treatment options to joint fusion that I should consider?
  6. How successful is joint fusion surgery in relieving pain and improving joint function?
  7. Will I require any additional procedures or treatments after joint fusion surgery?
  8. Are there any specific lifestyle changes or modifications I should make after joint fusion surgery?
  9. What is the long-term outlook for my joint after fusion surgery?
  10. Are there any specific precautions or warning signs I should be aware of after joint fusion surgery?

Reference

Authors: Shibuya N, Simmons A, Felix F. Journal: Clin Podiatr Med Surg. 2023 Jul;40(3):471-481. doi: 10.1016/j.cpm.2023.02.002. Epub 2023 Mar 21. PMID: 37236684