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A Long-Term Study of the Effect of Subtalar Arthrodesis on the Ankle and Hindfoot Joints

by MASS4D® Prescription Orthotics September 16, 2018

Abstracts

The authors evaluated clinical outcomes, degenerative joint changes, and ankle and hindfoot function after subtalar arthrodesis.

Between January 1, 1996, and August 31, 2011, 50 patients underwent isolated subtalar arthrodesis. The procedures were carried out with the patients supine, with a thigh tourniquet in place.

The Medical Outcomes Study 36-item Short Form Health Survey and the American Orthopaedic Foot and Ankle Society rating system were used for pre-operative and post-operative evaluations.

The 6 points for subtalar motion were not assigned; therefore, a postoperative score of 94 of 100 was regarded as the maximum possible score. The physical examination focused on pain at the ankle and hindfoot.


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Radiographs taken at the final follow-up visit included anteroposterior radiographs of the foot and ankle, Mortise’s ankle radiographs, inversion and eversion radiographs, and dorsoplantar radiographs of the foot.

The following parameters were assessed: tibiotalar angle, talarvertical angle (TVA), talocalcaneal angle, tibial-plantar minimal angle (TPA), calcaneoplantar angle (CPA), HH, and tibiotalar tilt angle (TTTA).

Radiographic assessment demonstrated evidence of degenerative changes in the talonavicular joint in 13 patients, in the cuneonavicular joint in five patients, in the calcaneocuboid joint in 21 patients, in the metatarsocuboid joint in ten patients, and in the ankle joint in five patients.

In this study, 36-item Short Form Health Survey and American Orthopaedic Foot and Ankle Society scores were significantly increased post-operatively.

The TPA of the affected sides was larger than that of the healthy side in inversion and eversion.

The results revealed that the inversion and eversion abilities of the ankle were, indeed, reduced but could be compensated for with inversion and eversion of the midfoot.

In conclusion, subtalar arthrodesis is an effective treatment for subtalar joint lesions, which could induce joint degeneration.

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References:

  1. Yang, C., Xu, X., Zhu, Y., Liu, J., Wei, B. (2016) A Long-Term Study of the Effect of Subtalar Arthrodesis on the Ankle and Hindfoot Joints. Journal of the American Podiatric Medical Association: January/February 2016, Vol. 106, No. 1, pp. 47-53

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