Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (8): 107-114.doi: 10.6040/j.issn.1671-7554.0.2020.0551

Previous Articles    

Lateral approach arthroscopic subtalar arthrodesis

WU Gang1, WANG Shilong1, DUAN Xiaoran1, WANG Yang2, ZHANG Hongchuan2   

  1. 1. Department of Minimal Invasive Foot &
    Ankle, Rehabilitation Hospital, National Research Center for Rehabilitation Technical Aids/Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability/Key Laboratory of Human Motion Analysis and Rehabilitation Technology of the Ministry of Civil Affairs, Beijing 110115, China;
    2. Department of Orthopaedics, Second Hospital of Chifeng Medical College, Chifeng 024000, Inner Mongolia, China
  • Published:2020-08-07

PDF (PC)

179

Abstract: Objective To evaluate the clinical efficacy of lateral arthroscopic subtalar arthrodesis(ASA). Methods Lateral ASA was performed in 21 patients with unilateral subtalar joint arthritis. The American Orthopaedic Foot & Ankle Society(AOFAS)score before and after operation, visual analogue scoring(VAS), union rate, excellent rate, union time as well as postoperative complications were evaluated. Results All operations were successful. During the follow-up of 12-41(average 22.7±4.2)months, no complication such as infection, necrosis, degenerative arthritis, neurovascular injury or hardware failure occurred; lateral impingement pain was observed in 1 case, screw cap irritation in 1 case, and partial posterior tibia nerve injury in 1 case. All 21 patients showed bone fusion on X-ray, with an average of(8.3±0.5)weeks of fusion. The AOFAS score rose from 41.73±3.87 before operation to 83.24±3.65 at final follow-up(P<0.01), and VAS score increased from 6.5±1.2 to 1.5±0.4(P<0.01). At the final follow-up, 1 patient had poor rating, 1 had medium rating, 1 had fair rating, 18 had good rating, and the fair and good ratings accounted for 90.48%. Conclusion Lateral ASA is a safe and effective treatment of subtalar joint diseases, with advantages of few trauma, fast recovery, few complications and high fusion rate.

Key words: Lateral approach, Subtalar arthrodesis, Arthroscope, Minimal invasive

CLC Number: 

  • R687.3
[1] Tuijthof GJ, Beimers L, Kerkhoffs GM, et al. Overview of subtalar arthrodesis techniques: options, pitfalls and solutions [J]. Foot Ankle Surg, 2010, 16(3): 107-116. doi:10.1016/j.fas.2009.07.002.[PubMed]
[2] Davies MB, Rosenfeld PF, Stavrou P, et al. A comprehensive review of subtalar arthrodesis [J]. Foot Ankle Int, 2007, 28(3): 295-297. doi:10.3113/FAI.2007.0295.
[3] Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes [J]. Foot Ankle Int, 1997, 18(3): 187-188. doi:10.1177/107110079701800315.
[4] Muraro GM, Carvajal PF. Arthroscopic arthodesis of subtalar joint [J]. Foot Ankle Clin, 2011, 16(1): 83-90. doi:10.1016/j.fcl.2010.12.007.
[5] Lee KB, Park CH, Seon JK, et al. Arthroscopic subtalar arthrodesis using a posterior 2-portal approach in the prone position [J]. Arthroscopy, 2010, 26(2): 230-238. doi:10.1016/j.arthro.2009.07.008.
[6] Mann RA, Beaman DN, Horton GA. Isolated subtalar arthrodesis [J]. Foot Ankle Int, 1998, 19(8): 511-519. doi:10.1177/107110079801900802.
[7] Rungprai C, Phisitkul P, Femino JE, et al. Outcomes and complications after open versus posterior arthroscopic subtalar arthrodesis in 121 patients [J]. J Bone Joint Surg Am, 2016, 98(8): 636-646. doi:10.2106/JBJS.15.00702.
[8] Parisien JS, Vangsness T. Arthroscopy of the Subtalar Joint: An Experimental Approach [J]. Arthroscopy, 1985, 1(1): 53-57. doi: 10.1016/s0749-8063(85)80079-7.
[9] Tasto JP. Arthroscopic subtalar arthrodesis [J]. Tech Foot Ankle Surg, 2003, 2(2): 122-128. doi:10.1097/00132587-200306000-00007.
[10] Dorsey ML, Liu PT, Roberts CC, et al. Correlation of arthrodesis stability with degree of joint fusion on MDCT [J]. AJR Am J Roentgenol, 2009, 192(2): 496-499. doi:10.2214/AJR.08.1254.
[11] Phisitkul P, Tochigi Y, Saltzman CL, et al. Arthroscopic visualization of the posterior subtalar joint in the prone position: a cadaver study [J]. Arthroscopy, 2006, 22(5): 511-515. doi:10.1016/j.arthro.2005.12.034.
[12] Cöster MC, Rosengren BE, Bremander A, et al. Comparison of the self-reported foot and ankle score(SEFAS)and the American orthopedic foot and ankle society score(AOFAS)[J]. Foot Ankle Int, 2014, 35(10): 1031-1036. doi:10.1177/1071100714543647.
[13] Nair AV, Shamsuddin K, John PS, et al. Correlation of visual analogue scale foot and ankle(VAS-FA)to AOFAS score in malleolar fractures using Indian language questionnaire [J]. Foot Ankle Surg, 2015, 21(2): 125-131. doi:10.1016/j.fas.2014.10.006.
[14] Mann RA, Baumgarten M. Subtalar fusion for isolated subtalar disorders. Preliminary report [J]. Clin Orthop Relat Res, 1988(226): 260-265.
[15] Easley ME, Trnka HJ, Schon LC, et al. Isolated subtalar arthrodesis [J]. J Bone Joint Surg Am, 2000, 82(5): 613-624. doi:10.2106/00004623-200005000-00002.
[16] Lundeen RO. Arthroscopic fusion of the ankle and subtalar joint [J]. Clin Podiatr Med Surg, 1994, 11(3): 395-406.
[17] Glanzmann MC, Sanhueza-Hernandez R. Arthroscopic subtalar arthrodesis for symptomatic osteoarthritis of the hindfoot: a prospective study of 41 cases [J]. Foot Ankle Int, 2007, 28(1): 2-7. doi:10.3113/FAI.2007.0001.
[18] Tasto JP. Arthroscopy of the subtalar joint and arthroscopic subtalar arthrodesis [J]. Instr Course Lect, 2006, 55: 555-564.
[19] Scranton PE Jr. Comparison of open isolated subtalar arthrodesis with autogenous bone graft versus outpatient arthroscopic subtalar arthrodesis using injectable bone morphogenic protein-enhanced graft [J]. Foot Ankle Int, 1999, 20(3): 162-165. doi:10.1177/107110079902000304.
[20] Flemister AS, Infante AF, Sanders RW, et al. Subtalar arthrodesis for complications of intra-articular calcaneal fractures [J]. Foot Ankle Int, 2000, 21(5): 392-399. doi:10.1177/107110070002100506.
[21] Coughlin MJ, Grimes JS, Traughber PD, et al. Comparison of radiographs and CT scans in the prospective evaluation of the fusion of hindfoot arthrodesis [J]. Foot Ankle Int, 2006, 27(10): 780-787. doi:10.1177/107110070602701004.
[22] Amendola A, Lee KB, Saltzman CL, et al. Technique and early experience with posterior arthroscopic subtalar arthrodesis [J]. Foot Ankle Int, 2007, 28(3): 298-302. doi:10.3113/FAI.2007.0298.
[23] Albert A, Deleu PA, Leemrijse T, et al. Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up [J]. Orthop Traumatol Surg Res, 2011, 97(4): 401-405. doi:10.1016/j.otsr.2011.02.005.
[24] Vilá-Rico J, Mellado-Romero MA, Bravo-Giménez B, et al. Subtalar arthroscopic arthrodesis: Technique and outcomes [J]. Foot Ankle Surg, 2017, 23(1): 9-15. doi:10.1016/j.fas.2015.11.007.
[25] Lee KB, Saltzman CL, Suh JS, et al. A posterior 3-portal arthroscopic approach for isolated subtalar arthrodesis [J]. Arthroscopy, 2008, 24(11): 1306-1310. doi:10.1016/j.arthro.2006.01.025.
[26] Eid MA, El-Soud MA, Mahran MA, et al. Minimally invasive, no hardware subtalar arthrodesis with autogenous posterior iliac bone graft [J]. Strategies Trauma Limb Reconstr, 2010, 5(1): 39-45. doi:10.1007/s11751-010-0081-0.
[27] Chahal J, Stephen DJ, Bulmer B, et al. Factors associated with outcome after subtalar arthrodesis [J]. J Orthop Trauma, 2006, 20(8): 555-561. doi:10.1097/01.bot.0000211156.13487.6a.
[28] Hintermann B, Valderrabano V, Nigg B. Influence of screw type on obtained contact area and contact force in a cadaveric subtalar arthrodesis model [J]. Foot Ankle Int, 2002, 23(11): 986-991. doi:10.1177/107110070202301102.
[29] Chuckpaiwong B, Easley ME, Glisson RR. Screw placement in subtalar arthrodesis: a biomechanical study [J]. Foot Ankle Int, 2009, 30(2): 133-141. doi:10.3113/FAI-2009-0133.
[30] Gosch C, Verrette R, Lindsey DP, et al. Comparison of initial compression force across the subtalar joint by two different screw fixation techniques [J]. J Foot Ankle Surg, 2006, 45(3): 168-173. doi:10.1053/j.jfas.2006.02.001.
[31] Devos Bevernage B, Goubau L, Deleu PA, et al. Posterior arthroscopic subtalar arthrodesis [J]. JBJS Essent Surg Tech, 2015, 5(4): e27. doi:10.2106/JBJS.ST.O.00021.
[32] Narita N, Takao M, Innami K, et al. Minimally invasive subtalar arthrodesis with iliac crest autograft through posterior arthroscopic portals: a technical note [J]. Foot Ankle Int, 2012, 33(9): 803-805. doi:10.3113/FAI.2012.0803.
[33] Vilá y Rico J, Jiménez Díaz V, Bravo Giménez B, et al. Results of arthroscopic subtalar arthrodesis for adult-acquired flatfoot deformity vs posttraumatic arthritis [J]. Foot Ankle Int, 2016, 37(2): 198-204. doi:10.1177/1071100715604237.
[34] Vilá Y Rico J, Ojeda Thies C, Parra Sanchez G. Arthroscopic posterior subtalar arthrodesis: surgical technique [J]. Arthrosc Tech, 2016, 5(1): e85-e88. doi:10.1016/j.eats.2015.10.009.
[35] Angthong C. Treatment of malunited calcaneal fracture with posttraumatic subtalar osteoarthritis using lateral endoscopic calcaneoplasty with posterior arthroscopic subtalar arthrodesis [J]. Arthrosc Tech, 2018, 7(3): e245-e249. doi:10.1016/j.eats.2017.08.077.
[36] Jones CP, Coughlin MJ, Shurnas PS. Prospective CT scan evaluation of hindfoot nonunions treated with revision surgery and low-intensity ultrasound stimulation [J]. Foot Ankle Int, 2006, 27(4): 229-235. doi:10.1177/107110070602700401.
[37] Thaunat M, Bajard X, Boisrenoult P, et al. Computer Tomography assessment of the fusion rate after posterior arthroscopic subtalar arthrodesis [J]. Int Orthop, 2012, 36(5): 1005-1010. doi:10.1007/s00264-011-1448-7.
[38] Coulomb R, Hsayri E, Nougarede B, et al. Do clinical results of arthroscopic subtalar arthrodesis correlate with CT fusion ratio? [J]. Orthop Traumatol Surg Res, 2019, 105(6): 1125-1129. doi:10.1016/j.otsr.2019.01.017.
[39] Diezi C, Favre P, Vienne P. Primary isolated subtalar arthrodesis: outcome after 2 to 5 years followup[J]. Foot Ankle Int, 2008, 29(12): 1195-1202. doi:10.3113/FAI.2008.1195.
[40] Ahn JH, Lee SK, Kim KJ, et al. Subtalar arthroscopic procedures for the treatment of subtalar pathologic conditions: 115 consecutive cases [J]. Orthopedics, 2009, 32(12): 891. doi:10.3928/01477447-20091020-12.
[41] Lintz F, Guillard C, Colin F, et al. Safety and efficiency of a 2-portal lateral approach to arthroscopic subtalar arthrodesis: a cadaveric study [J]. Arthroscopy, 2013, 29(7): 1217-1223. doi:10.1016/j.arthro.2013.04.016.
[42] Frey C, Halikus NM, Vu-Rose T, et al. A review of ankle arthrodesis: predisposing factors to nonunion [J]. Foot Ankle Int, 1994, 15(11): 581-584. doi:10.1177/107110079401501102.
[43] Williams MM, Ferkel RD. Subtalar arthroscopy: indications, technique, and results [J]. Arthroscopy, 1998, 14(4): 373-381. doi:10.1016/s0749-8063(98)70004-0.
[44] Carranza-Bencano A, Tejero-García S, Del Castillo-Blanco G, et al. Isolated subtalar arthrodesis through minimal incision surgery [J]. Foot Ankle Int, 2013, 34(8): 1117-1127. doi:10.1177/1071100713483114.
[45] Bernasconi A, Guillard C, Lintz F. Anterolateral arthroscopic posterior subtalar arthrodesis: the surgical technique [J]. Arthrosc Tech, 2017, 6(4): e1183-e1188. doi:10.1016/j.eats.2017.04.005.
No related articles found!
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd