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Arthroscopic Subtalar Arthrodesis by Posterior Approach

  • Francesco Lijoi
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Abstract

Arthroscopic subtalar arthrodesis is a safe and reproducible surgical technique in intractable subtalar pain or instability secondary to post-traumatic, rheumatic arthritis, or talocalcaneal coalitions. Other less frequent indications are primary osteoarthritis and gross instability. In neuropathic pathologies and chronic posterior tibial tendon ruptures, it can be taken into account only if subtalar pathology is not associated with deformities in other neighboring joints that need surgical fusion. Combined ankle and subtalar arthroscopic arthrodesis have been recently described with the patient in a prone position.

This technique can be performed with lateral or posterior approach. The arthroscopic posterior approach through the two classical posteromedial and posterolateral portals is combined with an anterolateral portal used at first for distraction of the joint, subsequently to debride the cartilage of the anterior area of the joint. The arthroscopic subtalar arthrodesis in the prone position offers some advantages over other types of surgery performed in the lateral position (open or arthroscopic), like the correct intraoperative evaluation of the hindfoot alignment and the easiness of placement of the screws.

Contraindications may include the presence of great deformities, infections, hardware after calcaneal or talar fractures, osteophytes precluding a work chamber, eccentric talus, severe malunion, failure of previous arthrodesis, bone defect requiring large grafting, associated midfoot deformity, and need of more than 10° of correction of the alignment of the hindfoot in valgus or in varus.

Supplementary material

Video 26.1

Subtalar Arthroscopic Arthrodesis by Posterior Approach (MP4 983393 kb)

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Francesco Lijoi
    • 1
  1. 1.Department of OrthopedicMalatesta Novello ClinicForli/CesenaItaly

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