Our Summary

This study aimed to compare two types of surgery for fusing the subtalar joint (a joint in the foot) - open surgery and arthroscopic (minimally invasive) surgery. The researchers wanted to see which type had fewer complications in the six weeks following surgery, as well as later complications, functional outcomes, pain, and patient satisfaction.

The study included 51 patients who needed this surgery between 2013 and 2020. Half of them had open surgery and the other half had arthroscopic surgery. The researchers checked for complications at different points in time up to 12 months after the surgery. They also measured how well the patients could use their foot, their pain levels, and how satisfied they were with the surgery.

The results showed that both types of surgery had the same rate of early complications (12%). In the open surgery group, these complications included nerve damage and infection. In the arthroscopic group, they included issues with wound healing and needing to replace a screw. There were more types of late complications in the arthroscopic group, including needing to remove a screw, non-union of the joint, nerve damage, and other issues.

However, when comparing the two types of surgery, there was no significant difference in the rates of early or late complications, functional outcomes, pain levels, or patient satisfaction. Therefore, the researchers concluded that arthroscopic surgery did not have fewer complications than open surgery. The secondary outcomes (like function, pain, and patient satisfaction) also did not significantly differ between the two types of surgery.

FAQs

  1. What were the two types of surgery for fusing the subtalar joint that the study compared?
  2. What were the early and late complications reported in the study for both open and arthroscopic surgeries?
  3. Were there any significant differences in complications, functional outcomes, pain levels or patient satisfaction between open surgery and arthroscopic surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about joint fusion is to follow post-operative instructions carefully, including keeping weight off the affected joint, attending physical therapy as recommended, and reporting any unusual symptoms or signs of infection to your healthcare provider promptly. It is important to follow up with your doctor regularly to monitor your progress and address any concerns that may arise.

Suitable For

Patients who are typically recommended for joint fusion surgery include those with severe arthritis, joint damage, instability, deformities, or chronic pain in the affected joint. Joint fusion surgery is often considered when other treatments, such as medication, physical therapy, or injections, have not provided sufficient relief. The decision to undergo joint fusion surgery is based on the individual patient’s specific condition and symptoms, as well as their overall health and lifestyle factors.

Timeline

Overall, the timeline for a patient undergoing joint fusion surgery involves:

  • Pre-surgery: Patients will have consultations with their orthopedic surgeon to discuss the procedure, risks, and benefits. They may also undergo pre-operative testing to ensure they are healthy enough for surgery.

  • Day of surgery: The patient will undergo either open or arthroscopic surgery to fuse the joint. The surgery typically takes a few hours, and the patient will be monitored in the recovery room before being discharged home.

  • Post-surgery: In the first six weeks following surgery, patients will be monitored for complications such as infection, nerve damage, and issues with wound healing. They may also undergo physical therapy to regain strength and mobility in the joint.

  • 6-12 months post-surgery: Patients will continue to be monitored for complications and undergo follow-up appointments with their surgeon. They will also assess their functional outcomes, pain levels, and overall satisfaction with the surgery.

Overall, the recovery timeline for joint fusion surgery can vary depending on the individual patient and the type of surgery performed. It is important for patients to follow their surgeon’s recommendations for post-operative care and attend all follow-up appointments to ensure a successful recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about joint fusion include:

  1. What are the potential complications of both open and arthroscopic surgery for joint fusion?
  2. How long is the recovery time for each type of surgery?
  3. What are the expected functional outcomes after surgery?
  4. How much pain can I expect during the recovery process?
  5. How long will I need to be on pain medication after surgery?
  6. What is the success rate of joint fusion surgery?
  7. Are there any alternative treatments to joint fusion that I should consider?
  8. What is the likelihood of needing additional surgery in the future after joint fusion?
  9. How soon can I return to normal activities after surgery?
  10. What can I do to optimize my recovery and improve the outcome of the surgery?

Reference

Authors: Stegeman M, Pruijn N, Susan S, Heesterbeek PJC, Louwerens JWK. Journal: Acta Orthop. 2024 Dec 10;95:723-729. doi: 10.2340/17453674.2024.42448. PMID: 39656213