Our Summary

This research paper is about a surgical procedure known as a triple arthrodesis, which involves fusing three joints in the foot. Sometimes, this procedure is combined with a tibiotalar arthrodesis, in which case it’s called a pantalar arthrodesis. The aim of these procedures is to correct deformities in the foot and create a stable, painless, and functional foot that can bear weight and be used for walking. This is achieved by creating a bone connection across the ankle and several joints in the foot. There are many ways to perform this surgery, and the best approach depends on the specific situation of the patient. Modern techniques have shown high success rates in terms of reducing pain and achieving a successful union of the bones.

FAQs

  1. What is a triple arthrodesis?
  2. What is the goal of a pantalar arthrodesis procedure?
  3. What are some of the modern techniques used in joint fusion that result in successful clinical union and pain relief?

Doctor’s Tip

A doctor might advise a patient undergoing joint fusion surgery to follow their post-operative rehabilitation plan closely to ensure optimal healing and recovery. This may include physical therapy exercises, weight-bearing restrictions, and regular follow-up appointments to monitor progress. It is important to communicate any concerns or changes in symptoms to your healthcare provider to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for joint fusion procedures, such as pantalar arthrodesis, include those with severe arthritis or deformity in the ankle, subtalar, talonavicular, and calcaneocuboid joints. This may be due to conditions such as osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, or severe flatfoot deformity. Patients who have failed conservative treatments such as physical therapy, bracing, medications, and injections may also be candidates for joint fusion surgery. Additionally, patients who have significant pain, instability, and difficulty walking or bearing weight on the affected foot may benefit from joint fusion to alleviate symptoms and improve function.

Timeline

  • Before joint fusion:
  1. Patient experiences chronic pain and instability in the affected joints.
  2. Patient undergoes various conservative treatments such as physical therapy, medications, and orthotics to manage symptoms.
  3. As conservative treatments fail to provide relief, patient and healthcare provider decide on joint fusion as a surgical option.
  4. Pre-operative assessments are performed to evaluate the patient’s overall health and determine the best approach for the fusion procedure.
  • After joint fusion:
  1. Surgery is performed to fuse the affected joints, creating stability and correcting deformity.
  2. Patient undergoes a period of immobilization and non-weightbearing to allow for proper healing of the fused joints.
  3. Physical therapy and rehabilitation are initiated to help regain strength, range of motion, and function in the fused joint.
  4. Over time, patient experiences improved stability, reduced pain, and increased function in the fused joint.
  5. Patient is able to return to daily activities and potentially resume activities that were limited due to joint pain and instability.

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 need any special accommodations or assistive devices after the surgery?
  5. How long can I expect the fusion to last and what are the chances of needing additional surgery in the future?
  6. What are the alternatives to joint fusion and why is fusion being recommended in my case?
  7. How will joint fusion surgery impact my overall mobility and ability to perform daily activities?
  8. What type of anesthesia will be used during the surgery and what is the expected level of pain post-operatively?
  9. Will I need physical therapy or other forms of post-operative care following joint fusion surgery?
  10. What are the long-term implications of joint fusion on my joint function and overall quality of life?

Reference

Authors: Chawla S, Brage M. Journal: Foot Ankle Clin. 2022 Dec;27(4):883-895. doi: 10.1016/j.fcl.2022.08.002. PMID: 36368803