Our Summary

This research paper discusses a common issue that orthopedic surgeons face, which is persistent pain following surgery, specifically after hindfoot fusion. The hindfoot, found at the back of the foot, is made up of several joints. These joints are often fused together during surgery for a variety of reasons such as degenerative changes, deformity correction, inflammation, neuropathic arthropathy, tarsal coalition, or primarily after trauma.

The main goal of hindfoot fusion is to create a pain-free foot that can fit into shoes without needing any extra support like orthotics or a brace. Some believe that it’s possible to correct deformities without involving one particular joint, known as the calcaneocuboid (CC) joint.

The paper emphasizes on the importance of managing patient expectations, particularly about potential complications that may arise post-surgery.

FAQs

  1. What are the common reasons for performing a hindfoot fusion surgery?
  2. What are the goals of a hindfoot fusion surgery?
  3. How important is the inclusion of the calcaneocuboid joint in deformity correction?

Doctor’s Tip

A helpful tip a doctor might give a patient about joint fusion is to follow a rehabilitation program as prescribed by the healthcare provider. This may include physical therapy exercises, stretching, and strengthening exercises to help improve range of motion and strength in the fused joint. It is important to adhere to the recommended guidelines to optimize the outcome of the fusion surgery and reduce the risk of complications. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can also support the healing process and overall joint health.

Suitable For

Patients who are typically recommended joint fusion are those with degenerative changes in the hindfoot joints, deformities that cannot be corrected through other methods, inflammatory or neuropathic arthropathy, tarsal coalition, or those who have experienced trauma. The goal of hindfoot fusion is to alleviate pain and improve function of the foot. It is important for orthopedic surgeons to manage patient expectations and discuss potential complications before recommending joint fusion surgery.

Timeline

Before joint fusion:

  1. Initial consultation with an orthopedic surgeon to discuss the need for joint fusion due to degenerative changes, deformity correction, inflammatory or neuropathic arthropathy, tarsal coalition, or trauma.
  2. Pre-operative assessments including imaging studies (X-rays, MRI) to evaluate the extent of joint damage and plan for the surgery.
  3. Discussion of the risks and benefits of joint fusion, as well as the expected outcomes and recovery process.

After joint fusion:

  1. Surgical procedure to fuse the affected hindfoot joints, typically the subtalar, talonavicular, and calcaneocuboid joints.
  2. Immediate post-operative care including pain management, wound care, and immobilization of the foot.
  3. Physical therapy and rehabilitation to regain strength and mobility in the foot and ankle.
  4. Follow-up appointments with the orthopedic surgeon to monitor healing progress and address any complications.
  5. Gradual return to normal activities and possibly the use of orthotics or braces to support the fused joint.
  6. Long-term follow-up to assess the success of the fusion, manage any ongoing pain or complications, and adjust treatment as needed.

What to Ask Your Doctor

  1. What is hindfoot fusion and why is it recommended for my condition?

  2. What are the potential risks and complications associated with hindfoot fusion surgery?

  3. How long is the recovery process after hindfoot fusion surgery?

  4. Will I need physical therapy after the surgery, and if so, for how long?

  5. What are the expected outcomes of hindfoot fusion surgery in terms of pain relief and improved mobility?

  6. What alternative treatment options are available for my condition besides hindfoot fusion surgery?

  7. How successful is hindfoot fusion surgery in terms of long-term pain relief and functional improvement?

  8. Are there any specific lifestyle changes or precautions I should take after the surgery to ensure a successful outcome?

  9. How soon can I expect to return to my normal activities and work after hindfoot fusion surgery?

  10. Are there any specific factors or conditions that may affect the success of hindfoot fusion surgery in my case?

Reference

Authors: Vier D, Ellington JK. Journal: Foot Ankle Clin. 2022 Jun;27(2):327-341. doi: 10.1016/j.fcl.2021.11.019. Epub 2022 May 11. PMID: 35680291