Arthroscopic Subtalar Arthrodesis: Does the Type of Fixation Modify Outcomes?

J Foot Ankle Surg. 2018 Jul-Aug;57(4):726-731. doi: 10.1053/j.jfas.2017.12.011. Epub 2018 Apr 27.

Abstract

The goal of the present study was to analyze a modified American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale score, time to union, and the incidence of fusion after isolated arthroscopic posterior subtalar arthrodesis using either 1 or 2 screws of different diameters. We reviewed a consecutive series of 65 patients, mean age 50.0 ± 15.6 years, including 38 males (58.5%) and 27 females (41.5%), who had undergone arthrodesis from May 2004 to February 2011. The mean follow-up duration was 57.5 (range 24 to 105) months. The patients were divided into 3 groups according to the fixation method used: group 1 (n = 12; 18.5%) underwent fixation with one 6.5-mm screw; group 2 (n = 40; 61.5%) with one 7.3-mm screw; and group 3 (n = 13; 20%) with two 7.3-mm screws. An overall statistically significant (p <.0001) improvement was seen in the modified AOFAS scale score for all 3 fixation groups; however, the difference was not statistically significant (p = .79) among the fixation groups. Fusion was achieved in 62 patients (95.4%) after a mean of 12.1 (range 9 to 16) weeks. The difference in the time to union was not statistically significant (p = .781) among the fixation groups. Nine patients (13.8%) experienced complications, and nonunion was significantly (p = .005) more prevalent in the single 6.5-mm screw group. In conclusion, all 3 screw configurations led to improved modified AOFAS scale scores, although nonunion was more common among patients fixed with a single 6.5-mm screw.

Keywords: arthroscopy; bone screw; calcaneus; internal fixation; subtalar joint; talus.

MeSH terms

  • Adult
  • Aged
  • Arthrodesis / adverse effects
  • Arthrodesis / instrumentation*
  • Arthrodesis / methods
  • Arthroscopy / adverse effects
  • Arthroscopy / instrumentation*
  • Arthroscopy / methods
  • Bone Screws*
  • Cohort Studies
  • Female
  • Humans
  • Joint Diseases / diagnostic imaging
  • Joint Diseases / etiology
  • Joint Diseases / surgery*
  • Male
  • Middle Aged
  • Radiography
  • Subtalar Joint*
  • Treatment Outcome
  • Young Adult