Advertisement

Arthroscopic Medial Approach for Modified Double Arthrodesis of the Foot

Published:April 09, 2016DOI:https://doi.org/10.1053/j.jfas.2016.03.013

      Abstract

      The single medial incision subtalar joint and talonavicular joint arthrodesis has been shown to be a useful alternative for the correction of hindfoot valgus deformity. We describe an arthroscopic method of joint preparation using this approach. The present case report included 6 consecutive patients aged 35 to 72 (mean ± standard deviation 55.8 ± 15.54) years (4 males [66.7%] and 2 females [33.3%]), who had undergone the medial approach for modified double arthrodesis of the foot. Of the 6 patients, 3 (50.0%) had undergone arthroscopic joint preparation and 3 (50.0%) traditional (manual) joint preparation. Osteobiologic agents were used in all patients. We found a shorter tourniquet time for the patients who had undergone an arthroscopic approach, with a mean of 110 ± 7.21 minutes, compared with a traditional joint preparation, with a mean of 121.3 ± 8.08 minutes. We also found a shorter time to radiographic union in the patients who had undergone an arthroscopic approach, all of whom showed signs of union at 6 weeks. Only 2 of the 3 patients in the traditional joint preparation group had achieved union at a mean of 10 ± 2.83 weeks, with 1 case resulting in nonunion. This technique could be a viable alternative to traditional methods of joint preparation by decreasing the operative time and improving the union rates.

      Level of Clinical Evidence

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Weinraub G.M.
        • Schuberth J.M.
        • Lee M.
        • Rush S.
        • Ford L.
        • Neufeld J.
        • Yu J.
        Isolated medial incisional approach to subtalar and talonavicular arthrodesis.
        J Foot Ankle Surg. 2010; 49: 326-330
        • Knupp M.
        • Schuh R.
        • Stufkens S.A.S.
        • Bolliger L.
        • Hintermann B.
        Subtalar and talonavicular arthrodesis through a single medial approach for the correction of severe planovalgus deformity.
        J Bone Joint Surg Br. 2009; 91: 612-615
        • De Wachter J.
        • Knupp M.
        • Hintermann B.
        Double-hindfoot arthrodesis through a single medial approach.
        Techn Foot Ankle Surg. 2007; 6: 1-6
        • Jeng C.L.
        • Tankson C.J.
        • Myerson M.S.
        The single medial approach to triple arthrodesis: a cadaver study.
        Foot Ankle Int. 2006; 27: 1122-1125
        • Brilhault J.
        Single medial approach to modified double arthrodesis in rigid flatfoot with lateral deficient skin.
        Foot Ankle Int. 2009; 30: 21-26
        • Vilá Y Rico J.V.
        • Jiménez Díaz J.
        • Bravo Giménez B.
        • Mellado Romero M.Á.
        • Ojeda Thies C.
        Results of arthroscopic subtalar arthrodesis for adult-acquired flatfoot deformity vs posttraumatic arthritis.
        Foot Ankle Int. 2016; 37: 198-204
        • Beimers L.
        • de Leeuw P.A.J.
        • van Dijk C.N.
        A 3-portal approach for arthroscopic subtalar arthrodesis.
        Knee Surg Sports Traumatol Arthrosc. 2009; 17: 830-834
        • El Shazly O.
        • Nassar W.
        • El Badrawy A.
        Arthroscopic subtalar fusion for post-traumatic subtalar arthritis.
        Arthroscopy. 2009; 25: 783-787
        • Jerosch J.
        Subtalar arthroscopy—indications and surgical technique.
        Knee Surg Sports Traumatol Arthrosc. 1998; 6: 122-128
        • Lee K.B.
        • Saltzman C.L.
        • Suh J.-S.
        • Wasserman L.
        • Amendola A.
        Technical note: a posterior 3-portal arthroscopic approach for isolated subtalar arthrodesis.
        Arthroscopy. 2008; 24: 1306-1310
        • Muraro G.M.
        • Carvajal P.F.
        Arthroscopic arthrodesis of subtalar joint.
        Foot Ankle Clin North Am. 2011; 16: 83-90
        • Tasto J.P.
        Arthroscopic subtalar arthrodesis.
        Techn Foot Ankle Surg. 2003; 2: 122-128
        • Tuijthof G.J.
        • Beimers L.
        • Kerkhoffs G.M.
        • Dankelman J.
        • van Dijk C.N.
        Overview of subtalar arthrodesis techniques: options, pitfalls and solutions.
        Foot Ankle Surg. 2010; 16: 107-116
        • Hughes A.M.
        • Gosling O.
        • McKenzie J.
        • Amirfeyz R.
        • Winson I.G.
        Arthroscopic triple fusion joint preparation using two lateral portals: a cadaveric study to evaluate efficacy and safety.
        Foot Ankle Surg. 2014; 20: 135-139
        • Jagodzinski N.A.
        • Parsons A.M.
        • Parsons S.W.
        Arthroscopic triple and modified double hindfoot arthrodesis.
        Foot Ankle Surg. 2015; 21: 97-102