A Comprehensive Review of Subtalar Arthrodesis

Davies, Mark B.; Rosenfeld, Peter; Stavrou, Peter; Saxby, Terence S.

doi:10.3113/fai.2007.0295

Cited by 105 publications

(79 citation statements)

References 15 publications

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“…Isolated subtalar arthrodesis is the preferred procedure in patients with clinical and radiographic arthritis confined to the subtalar joint that is refractory to conservative treatment [11,14,18,24]. Additive fusions of the talonavicular and calcaneocuboid joints, resulting in double [29] and triple arthrodeses [28,31], respectively, are done when arthritic joint changes, deformity and symptoms clearly extend to the midtarsal joints (Chopart's).…”

Section: Introductionmentioning

confidence: 99%

How Do Hindfoot Fusions Affect Ankle Biomechanics: A Cadaver Model

Hutchinson

Baxter

Gilbert

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background While successful subtalar joint arthrodesis provides pain relief, resultant alterations in ankle biomechanics need to be considered, as this procedure may predispose the remaining hindfoot and tibiotalar joint to accelerated degenerative changes. However, the biomechanical consequences of isolated subtalar joint arthrodesis and additive fusions of the Chopart's joints on tibiotalar joint biomechanics remain poorly understood. Questions/purposes We asked: What is the effect of isolated subtalar fusion and sequential Chopart's joint fusions of the talonavicular and calcaneocuboid joints on tibiotalar joint (1) mechanics and (2) kinematics during loading for neutral, inverted, and everted orientations of the foot? Methods We evaluated the total force, contact area, and the magnitude and distribution of the contact stress on the articular surface of the talar dome, while simultaneously tracking the position of the talus relative to the tibia during loading in seven fresh-frozen cadaver feet. Each foot was loaded in the unfused, intact control condition followed by three randomized simulated hindfoot arthrodesis modalities: subtalar, double (subtalar and talonavicular), and triple (subtalar, talonavicular, and calcaneocuboid) arthrodesis. The intact and arthrodesis conditions were tested in three alignments using a metallic wedge insert: neutral (flat), 10°i nverted, and 10°everted. Results Tibiotalar mechanics (total force and contact area) and kinematics (external rotation) differed owing to hindfoot arthrodeses. After subtalar arthrodesis, there were Each author certifies that he or she, or a member of their immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® decreases in total force (445 ± 142 N, 95% CI, 340-550 N, versus 588 ± 118 N, 95% CI, 500-676 N; p \ 0.001) and contact area (282 mm 2 , 95% CI, 222-342 mm 2 , versus 336 ± 96 mm 2 , 95% CI, 265-407 mm 2 ; p \ 0.026) detected during loading in the neutral position; these changes also were seen in the everted foot position. Hindfoot arthrodesis also was associated with increased external rotation of the tibiotalar joint during loading: subtalar arthrodesis in the neutral loading position (3.3°± 1.6°; 95% CI, 2°-4.6°; p = 0.004) and everted loading position (4.8°± 2.6°; 95% CI, 2.7°-6.8°; p = 0.043); double arthrodesis in neutral (4.4°± 2°; 95% CI, 2.8°-6°; p = 0.003) and inverted positions (5.8°± 2.6°; 95% CI, 3.7°-7.9°; p = 0.002), and triple arthrodesis in all loaded orientations including neutral (4.5°±1.8°; 95% CI, 3.1°-5.9°; p = 0.002), inverted (6.4°± 3.5°; 95% CI, 3.6°-9.2°; p = 0.009), and everted (3.6°± 2°; 95% CI, 2°-5.2°; p = 0.053) positions. Finally, after subtalar arthrodesis, additive fusions at Chopart's joints did not appear to result in additional observe...

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Section: Introductionmentioning

confidence: 99%

How Do Hindfoot Fusions Affect Ankle Biomechanics: A Cadaver Model

Hutchinson

Baxter

Gilbert

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…Advantages of it are said to be an easier initial approach, availability of the denser talar bone and a reduced risk of damage to the neurovascular bundle [2,6,10].…”

Section: Discussionmentioning

confidence: 98%

“…During the last few decades internal fixation with screws has become established as the standard procedure for isolated subtalar arthrodesis [2,3,10]. In a biomechanical study, Chuckpaiwong et al [9] showed that a screw configuration (SC) using two arthrodesis screws instead of one could triple the initial compressive forces and also significantly increase rotatory stability of the arthrodesis construct [9].…”

Section: Introductionmentioning

confidence: 98%

Subtalar arthrodesis stabilisation with screws in an angulated configuration is superior to the parallel disposition: a biomechanical study

Eichinger

Schmölz

Brunner

et al. 2015

International Orthopaedics (SICOT)

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“…Subtalar arthrodesis is an established treatment for severe hindfoot disorders when more conservative measures have failed, and fixation with large cannulated screws has become a standard method of achieving this (Davies et al, 2007;Easley et al, 2000). It is widely accepted that adequately rigid fixation and compression at the time of surgery are paramount for success of subtalar arthrodesis.…”

Section: Discussionmentioning

confidence: 99%

“…The goal of this surgery is solid fusion of the subtalar joint in a physiologically favorable position to eliminate painful motion. Internal fixation with screws is the method most commonly used to achieve fusion (Davies et al, 2007;Easley et al, 2000;Haskell et al, 2004;Mann et al, 1998), with attendant non-union rates ranging from 2% to 30% (Easley et al, 2000;Mann et al, 1998;Donley and Ward, 2002;Kolodziej and Nunley, 2001;Sammarco and Tablante, 1998). Union rate is negatively influenced by comorbidities such as tobacco use and diabetes, compromised bone at the arthrodesis site, and failed primary arthrodesis (Easley et al, 2000).…”

Section: Introductionmentioning

confidence: 97%