Arthroscopic subtalar arthrodesis through the sinus tarsi portal approach: A series of 77 cases

Walter, Richard; Walker, R.; Butler, Michael B.; Parsons, S.W.

doi:10.1016/j.fas.2017.04.006

Cited by 21 publications

(38 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All selected studies were identified using the literature search strategy, as the review of reference sections did not identify additional articles for inclusion. Overall, 8 studies 5 , 9 , 12 , 18 , 21 , 22 , 24 , 31 examined prone patients with 2 posterior portals (n = 111; 22.9%), 7 articles 4 , 11 , 13 , 16 , 27 , 30 , 35 evaluated lateral portals in the supine or lateral position (n = 182; 37.6%), and 5 studies 2 , 3 , 6 , 26 , 34 examined patients in the prone position with 3 portals (n = 191; 39.5%). The mean MCMS of included studies was found to be 38.4 (range, 10-63) ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…30 The procedure was originally performed with the patient in the lateral decubitus or supine position using anterolateral and posterolateral portals based around the fibula with good results. 11 , 13 , 27 , 35 More recently, several authors 2 , 3 , 5 , 21 , 24 , 26 , 31 have advocated for prone positioning utilizing posteromedial and posterolateral portals, as first described by van Dijk et al 32 in 2000. Proponents of the prone position cite improved intra-articular visualization with a limited need for traction and more thorough preparation of the posterior facet for fusion.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Do Patient Positioning and Portal Placement for Arthroscopic Subtalar Arthrodesis Matter?

Shamrock

Amendola

Glass

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Arthroscopic subtalar arthrodesis was first described over 2 decades ago and originally performed in the lateral decubitus or supine position using anterolateral and posterolateral portals situated about the fibula. More recently, several authors have advocated for prone positioning utilizing posteromedial and posterolateral portals with an optional accessory lateral portal. To date, a comparison of these techniques has been limited. Purpose: To determine the effect of patient positioning and portal placement on complication rates after arthroscopic subtalar arthrodesis. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Patients were placed into 1 of 3 groups: the lateral group if they were positioned lateral or supine with lateral-based portals; the 2-portal prone group if they were positioned prone with posteromedial and posterolateral portals; or the 3-portal prone group if posteromedial, posterolateral, and accessory lateral portals were utilized in the prone position. Inverse variance–weighted fixed-effects models were used to evaluate pooled estimates. Results: A total of 20 studies examining 484 feet in 468 patients with a mean follow-up of 36.1 months were included for analysis. Overall, 8 studies examined patients in the prone position with 2 posterior portals (n = 111; 22.9%), 7 articles evaluated lateral portals (n = 182; 37.6%), and 5 studies examined patients in the prone position with 3 portals (n = 191; 39.5%). The total complication rate was similar ( P = .620) between the 2-portal prone (18.9%), 3-portal prone (17.8%), and lateral (17.6%) groups. There was no difference observed in the rate of complications secondary to portal placement ( P ≥ .334), rate of painful hardware ( P ≥ .497), and rate of repeat surgery ( P ≥ .304). The 2-portal prone group had a significantly higher rate of nonunion than the lateral group (8.1% vs 1.1%, respectively; P = .020) but not the 3-portal prone group (5.8%; P = .198). Conclusion: The current study demonstrated a higher rate of nonunion following arthroscopic subtalar arthrodesis with prone patient positioning using posteromedial and posterolateral portals without an accessory lateral portal.

show abstract

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Do Patient Positioning and Portal Placement for Arthroscopic Subtalar Arthrodesis Matter?

Shamrock

Amendola

Glass

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…The described arthroscopic approaches for subtalar arthrodesis make use posterior and/or lateral approach. 1,2,7 LEAP subtalar arthrodesis uses 2 lateral portals placed at different location compared with the described lateral portals for arthroscopic subtalar arthrodesis. The strategic placement of portals facilitates creation of the lateral endoscopic working space, makes triangulation and maneuvering easier, and avoids injury to the sural nerve (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…Arthroscopic subtalar arthrodesis is technically demanding but provides better visualization of the articular surfaces and is safer for the surrounding soft tissues compared with the open approach. Early published reports of the arthroscopic subtalar arthrodesis from the lateral sinus tarsi approach 1 and posterior approach 2 have shown promising results, with high rates of union and fewer wound healing complications. However, there are concerns about access to all facets of subtalar joint, nerve injury, and deformity correction.…”

mentioning

confidence: 99%

Lateral Hind-Foot Endoscopic Anterolateral/Posterolateral (LEAP) Subtalar Arthrodesis: An Effective Minimally Invasive Technique to Achieve Subtalar Fusion and Deformity Correction

Perera

Kandhari

Portal-Banker

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

Arthrodesis surgery aims to provide relief for chronic joint pain and correct limb alignment by achieving a stable union between articulating bones. The key factors to achieving sound arthrodesis is adequate debridement of arthritic cartilage and creating well-apposed bleeding subchondral bone surfaces without compromising the surrounding soft tissue envelope. Arthroscopic subtalar arthrodesis is technically demanding but provides better visualization of the articular surfaces and is safer for the surrounding soft tissues compared to the open approach. Early published reports of the arthroscopic subtalar arthrodesis from the lateral sinus tarsi approach and posterior approach have shown promising results with high rates of union and less wound healing complications. However, there are concerns about access to all facets of subtalar joint, nerve injury, and deformity correction. In this technique, the article authors describe the lateral endoscopic anterolateral/posterolateral (LEAP) approach for subtalar arthrodesis to improve visualization and access to all facets of the subtalar joint to ensure adequate preparation of apposing surfaces, sound union, and facilitate deformity correction of hind-foot. Strategic portal placement also avoids injury to sural nerve. This is a safe and effective minimally invasive technique for subtalar arthrodesis.

show abstract

“…Arthroscopic procedures are less invasive than conventional open techniques and posterior arthroscopy, performed in ventral decubitus, may be more advantageous than the conventional anterior and/or lateral approaches (4,16) .…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic subtalar arthrodesis – results and complications

et al. 2020

View full text Add to dashboard Cite

Objective: The objective of this study is to evaluate the results and complications of the subtalar arthrodesis technique conducted via arthroscopy. Methods: Searches were run on PubMed/Medline and Google Scholar for publications dated from 2007 to 2020. Original articles were included that reported the results of at least one comparative postoperative scale. Methodological quality was assessed using the PRISMA tool. Union rate, complications, and the American Orthopedic Foot and Ankle Society (AOFAS) score were prioritized. Results: A total of 124 references were identified and, after application of the inclusion and exclusion criteria and the PRISMA tool, 9 articles were eligible. A total of 180 patients were analyzed, with mean postoperative follow-up of 18 months (± 6) and with before and after AOFAS scores varying from 44 to 79 with p<0.001, demonstrating statistical relevance with significant improvement of AOFAS scores during the postoperative period. Deformity correction, improvement of pain, and rates of union were good and there was clinical improvement according to postoperative AOFAS scores, with few complications. However, the heterogeneous nature of studies, withvariations in techniques and samples, prevents generalization of the findings. Conclusion: The results of arthroscopic surgery for subtalar arthrodesis are good and rates of complications are low, but there are stillfew studies with high evidence levels that demonstrate the efficacy of the technique, although preliminary results are encouraging. Level of Evidence I; Therapeutic Studies; Systematic Review.

show abstract

Arthroscopic subtalar arthrodesis through the sinus tarsi portal approach: A series of 77 cases

Cited by 21 publications

References 32 publications

Do Patient Positioning and Portal Placement for Arthroscopic Subtalar Arthrodesis Matter?

Do Patient Positioning and Portal Placement for Arthroscopic Subtalar Arthrodesis Matter?

Lateral Hind-Foot Endoscopic Anterolateral/Posterolateral (LEAP) Subtalar Arthrodesis: An Effective Minimally Invasive Technique to Achieve Subtalar Fusion and Deformity Correction

Arthroscopic subtalar arthrodesis – results and complications

Contact Info

Product

Resources

About