Our Summary

This study looked at a surgical procedure called tibiotalocalcaneal arthrodesis (TTCA) which is often used to treat hindfoot arthritis. The researchers wanted to see whether including an additional surgical step (open debridement of the subtalar joint) was necessary for the procedure to be successful.

They examined the outcomes of two groups of patients who had undergone the TTCA procedure: one group had the additional subtalar joint procedure, while the other group did not.

The results showed that the group who had the additional procedure had higher rates of successful subtalar fusion (the bones in the foot properly joining together). However, this group also had higher rates of nerve complications.

The group who did not have the additional procedure had lower complication rates and they also achieved satisfactory outcomes and pain relief.

The researchers concluded that the additional subtalar joint procedure can help achieve optimal fusion, but it’s not always necessary. In certain cases, like when the patient’s soft tissue is already compromised, skipping the additional procedure can still achieve good results and provide pain relief.

FAQs

  1. What is tibiotalocalcaneal arthrodesis (TTCA) and why is it performed?
  2. What were the key findings from this study on the additional subtalar joint procedure during TTCA surgery?
  3. Is the additional subtalar joint procedure always recommended during TTCA surgery?

Doctor’s Tip

A doctor might tell a patient considering joint fusion that while additional procedures can help optimize fusion, they may also come with higher risks of complications. It’s important to weigh the potential benefits and risks with your doctor to determine the best treatment plan for your specific situation. Additionally, following post-operative care instructions and engaging in physical therapy as recommended can help improve outcomes and speed up recovery.

Suitable For

Patients who are typically recommended joint fusion procedures are those who have severe arthritis or joint damage in the hindfoot that is causing significant pain and limited mobility. These patients may have tried other non-surgical treatments without success and are looking for a more permanent solution to their joint problems. Joint fusion may also be recommended for patients who have had previous joint surgeries that have been unsuccessful.

In the case of tibiotalocalcaneal arthrodesis (TTCA) with or without open debridement of the subtalar joint, patients with hindfoot arthritis and significant joint damage may be candidates for this procedure. It is important for patients to discuss their individual case with their healthcare provider to determine if joint fusion is the best treatment option for them.

Timeline

Before joint fusion:

  • Patient experiences pain, stiffness, and limited mobility in the affected joint
  • Patient undergoes diagnostic tests (such as X-rays, MRI, or CT scans) to determine the extent of damage and the need for surgery
  • Patient consults with an orthopedic surgeon to discuss treatment options, including joint fusion
  • Patient undergoes pre-operative preparation, which may include physical therapy, medication management, and lifestyle modifications

After joint fusion:

  • Patient undergoes the joint fusion surgery, which involves fusing the bones in the affected joint together using screws, plates, or other hardware
  • Patient experiences post-operative pain, swelling, and limited mobility, and may require physical therapy or rehabilitation to regain strength and function
  • Over time, the bones in the fused joint gradually grow together, stabilizing the joint and reducing pain
  • Patient experiences improved function and mobility in the affected joint, with reduced pain and increased stability
  • Patient continues to follow up with their orthopedic surgeon for monitoring and management of any complications or ongoing symptoms.

What to Ask Your Doctor

  1. Is joint fusion the best treatment option for my hindfoot arthritis?
  2. What are the potential risks and complications associated with the TTCA procedure?
  3. Do I need to have the additional open debridement of the subtalar joint for successful fusion, or can it be skipped in my case?
  4. What can I expect in terms of pain relief and functional improvement after the procedure?
  5. How long is the recovery process and what type of rehabilitation will be needed?
  6. Are there any alternative treatments or procedures that I should consider?
  7. What is the success rate of the TTCA procedure in patients with hindfoot arthritis?
  8. Are there any specific factors in my case that may affect the outcome of the procedure?
  9. How often will I need to follow up with you after the surgery?
  10. What should I do if I experience any complications or concerns during the recovery period?

Reference

Authors: Ozkul B, Akbulut D, Kürk MB, Albayrak K, Pehlivanoglu G, Demir B. Journal: J Orthop Surg Res. 2025 Apr 23;20(1):408. doi: 10.1186/s13018-025-05817-w. PMID: 40269925