Midterm Outcome of Subtalar Joint Revision Arthrodesis

Abstract

Background: The outcomes of revision subtalar arthrodesis have received relatively little focus in research compared with primary subtalar arthrodesis outcomes. This study aimed to assess the midterm clinical and radiologic results of subtalar joint revision arthrodesis and to analyze the risk factors that might influence the outcome of this procedure. Methods: We performed a retrospective review of 20 patients after subtalar joint revision arthrodesis for malunion, using interposition of iliac crest bone graft. The mean age was 55.75 years and the average follow-up lasted for 48.93 months. Eighty-five percent of the patients had at least 1 risk factor identified prior to revision. Patients’ satisfaction and functional outcomes were evaluated with the American Orthopaedic Foot & Ankle Society Scale (AOFAS), the Foot and Ankle Outcome Score (FAOS), the Foot Function Index (FFI), and dynamic pedobarography. Results: A fusion rate of 80% was recorded whereas 20% of the cases ended with a painful pseudarthrosis requiring additional surgery. Pedobarographic measurements demonstrated that loading has a propensity toward the lateral column, but no substantial effect on the gait of patients. In this group, the following patient-reported outcomes were observed: 70% of the patients were satisfied, 20% of the patients found the result fair, and 10% were not satisfied with the results. Compared with the preoperative evaluation, postoperative functional scores showed significant improvement on the FOAS, AOFAS, and FFI outcome scales. Conclusions: Revision arthrodesis of the subtalar joint remains a challenging issue with a relatively high rate of nonunion, especially in a population of patients with multiple risk factors. Level of Evidence: Level IV, retrospective case series.

Primary subtalar arthrodesis in the treatment of comminuted calcaneal fractures: a functional and quality of life analysis

“…In this study, the laterality (p=0.355), sex (p=0.371), age (p=0.313), fracture time (p=0.374), Sanders classification (p=0.355), and postarthrodesis valgus (p=0.410) parameters were not statistically significant as predictive of the AOFAS functional score. It should be stressed that the essential Böhler and Gissane's angles and the calcaneus height were restored with a good correction, and all patients presented bone consolidation, corroborating the findings described in the literature, which the bone fusion rate is 65-100% (19) and the pseudoarthrosis rate is 0-24% (20) after primary arthrodesis.…”

Optimizing Subtalar Arthrodesis: A Human Cadaveric Evaluation of a Novel Partially-Threaded Screw Combination in the Delta Configuration

“…All used screws in the present study were with a 6.5 mm diameter, as they feature a comparable pull-out force as 7.3 mm or 8.0 mm cannulated screws [ 16 , 35 , 36 ].…”

Subtalar Arthrodesis Union Rates With and Without Adjacent Ankle Arthrodesis

“…1,8,11,12,20 Nonunion rates of up to 40% have been reported, but most modern studies report much lower rates. [1][2][3]8 Subtalar arthritis may develop in patients with ankle arthritis. The surgical treatment of end-stage ankle arthritis includes ankle arthrodesis or ankle replacement.…”

“…1,8,11,12,20 Nonunion rates of up to 40% have been reported, but most modern studies report much lower rates. 1-3,8…”