Our Summary

This research paper is about a type of foot surgery called hindfoot arthrodesis, often needed for severe foot deformities caused by conditions like arthritis. The study is trying to figure out whether it’s better to fuse two joints (double arthrodesis) or three joints (triple arthrodesis) during the surgery.

The researchers looked at 184 articles published between 2005 and 2017, but only 13 met their criteria. They studied the results of these surgeries on a total of 343 feet.

They found that the success rate of fusing the joints was about the same for both double and triple arthrodesis, and the time it took for the joints to fuse was also similar. However, triple arthrodesis has some risks like longer surgery times, complications, remaining deformity, higher cost, and possibility of arthritis around the joint.

So, the authors suggest that double arthrodesis, which has nearly the same success rate and fusion time but fewer risks than triple arthrodesis, is a better choice for this type of foot surgery.

FAQs

  1. What is the focus of this research paper about foot surgery?
  2. What were the key findings of the research about double and triple arthrodesis?
  3. Why do the authors suggest that double arthrodesis might be a better choice than triple arthrodesis?

Doctor’s Tip

A doctor might advise a patient considering joint fusion surgery to discuss with their healthcare provider the option of double arthrodesis as a potentially less risky alternative to triple arthrodesis. It is important for the patient to weigh the potential benefits and risks of each type of surgery before making a decision.

Suitable For

Patients who are typically recommended for joint fusion, specifically hindfoot arthrodesis, are those with severe foot deformities caused by conditions like arthritis. These patients may have significant pain, stiffness, and instability in their foot joints that have not responded well to conservative treatments such as physical therapy, medications, or orthotics. Additionally, patients with conditions like flatfoot deformity, cavus foot deformity, or post-traumatic arthritis may also benefit from joint fusion surgery.

Patients who have failed previous surgeries or have progressive deformities that are impacting their ability to walk and perform daily activities may also be candidates for joint fusion. It is important for patients to undergo a thorough evaluation by a foot and ankle specialist to determine if joint fusion is the best treatment option for their specific condition.

Timeline

-Before joint fusion:

  1. Patient is evaluated by a medical professional for severe foot deformities caused by conditions like arthritis.
  2. Patient undergoes various imaging tests such as X-rays, CT scans, or MRI scans to assess the extent of the deformity and plan for the surgery.
  3. Patient may undergo conservative treatment options such as physical therapy or medication to manage symptoms before considering surgery.
  4. Surgical options are discussed with the patient, including the choice between double arthrodesis and triple arthrodesis.
  5. Surgical consent is obtained from the patient before the procedure.

-After joint fusion:

  1. Patient undergoes the joint fusion surgery, either double arthrodesis or triple arthrodesis, based on the evaluation and recommendation of the medical team.
  2. Patient is monitored closely in the hospital for a few days post-surgery to manage pain and monitor for any complications.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the foot after the surgery.
  4. Patient follows up with their medical team for regular check-ups to monitor the fusion process and assess the success of the surgery.
  5. Patient may need to make lifestyle modifications and follow specific guidelines to ensure proper healing and long-term success of the joint fusion surgery.

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, and if so, for how long?
  4. What type of anesthesia will be used during the surgery?
  5. How long will the fusion process take, and what can I expect during that time?
  6. What type of post-operative care will be required?
  7. Are there any alternative treatments to joint fusion that I should consider?
  8. How will joint fusion surgery affect my mobility and daily activities?
  9. What is the long-term outlook for joint fusion surgery in terms of pain relief and joint function?
  10. How many of these surgeries have you performed, and what is your success rate with them?

Reference

Authors: Cates NK, Mayer A, Tenley J, Wynes J, Tefera E, Steinberg JS, Kim PJ, Weinraub GM. Journal: J Foot Ankle Surg. 2022 Jul-Aug;61(4):907-913. doi: 10.1053/j.jfas.2022.01.012. Epub 2022 Jan 19. PMID: 35221217