Comparison of Radiographs and CT Scans in the Prospective Evaluation of the Fusion of Hindfoot Arthrodesis

Coughlin, Michael J.; Grimes, J. Speight; Traughber, Paul D.; Jones, Carroll P.

doi:10.1177/107110070602701004

Cited by 133 publications

(101 citation statements)

References 32 publications

(96 reference statements)

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“…Patient-reported outcome measures are being increasingly used to assess patient outcomes after medical and surgical procedures (22), and SF-12 has been widely studied to assess the clinical results after foot and ankle procedures (23)(24)(25). In the present study, the SF-12 physical and mental component scores at the last follow-up visit were 52.5 and 56.4, respectively.…”

Section: Discussionmentioning

confidence: 64%

Posterior Arthroscopic Subtalar Arthrodesis: Clinical and Radiologic Review of 19 Cases

Oliva

Falcão

Cerqueira

et al. 2017

The Journal of Foot and Ankle Surgery

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Level of Clinical Evidence: 4Keywords: ankle arthroscopy posterior subtalar arthroscopy subtalar arthritis subtalar arthrodesis a b s t r a c t Arthroscopic subtalar arthrodesis has recently gained popularity in the treatment of primary subtalar or posttraumatic arthritis, coalition, or inflammatory diseases with subtalar arthritis. The present study reports the clinical and radiologic results of 19 patients (19 feet) who underwent posterior arthroscopic subtalar arthrodesis using 2 posterior portals. A total of 19 posterior arthroscopic subtalar arthrodeses (minimum follow-up of 24 months) performed without a bone graft and with 2 parallel screws were prospectively evaluated. The fusion rate was 94% (mean time to fusion 9.8 weeks). Modified American Orthopaedic Foot and Ankle Society anklehindfoot scale score (maximum 94 points) improved significantly from 43 to 80 points and the visual analog scale for pain score improved from 7.6 to 1.2. The 12-item short-form physical and mental scores at the last follow-up point were 52.5 and 56.4, respectively. One (5.3%) patient underwent open repeat fusion for nonunion, 2 (10.5%) patients required a second procedure for implant removal, and 1 (5.3%) experienced reversible neuropraxia. In conclusion, posterior arthroscopic subtalar arthrodesis is a safe technique with a good union rate and a small number of complications in patients with no or very little hindfoot deformity.

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Section: Discussionmentioning

confidence: 64%

Posterior Arthroscopic Subtalar Arthrodesis: Clinical and Radiologic Review of 19 Cases

Oliva

Falcão

Cerqueira

et al. 2017

The Journal of Foot and Ankle Surgery

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“…Finally, it should be noted that in this study all patients with a hindfoot arthrodesis were deemed to have achieved bony union on the basis of clinical examination and radiographic analysis. Coughlin et al 5 demonstrated in a series of hindfoot arthrodeses that standard radiographs substantially overestimate the rate of hindfoot fusion when compared to computed tomography (CT) and showed CT scans are significantly more reliable in determining bony union. Given that radiographs were used as the sole imaging modality to assess union in our patients, it is possible that some patients in the fusion group had unappreciated nonunions that may have served as a confounding factor.…”

Section: Discussionmentioning

confidence: 99%

Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis

et al. 2014

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Background: Ipsilateral hindfoot arthrodesis in combination with total ankle replacement (TAR) may diminish functional outcome and prosthesis survivorship compared to isolated TAR. We compared the outcome of isolated TAR to outcomes of TAR with ipsilateral hindfoot arthrodesis. Methods: In a consecutive series of 404 primary TARs in 396 patients, 70 patients (17.3%) had a hindfoot fusion before, after, or at the time of TAR; the majority had either an isolated subtalar arthrodesis (n = 43, 62%) or triple arthrodesis (n = 15, 21%). The remaining 334 isolated TARs served as the control group. Mean patient follow-up was 3.2 years (range, 24-72 months). Results: The SF-36 total, AOFAS Hindfoot-Ankle pain subscale, Foot and Ankle Disability Index, and Short Musculoskeletal Function Assessment scores were significantly improved from preoperative measures, with no significant differences between the hindfoot arthrodesis and control groups. The AOFAS Hindfoot-Ankle total, function, and alignment scores were significantly improved for both groups, albeit the control group demonstrated significantly higher scores in all 3 scales. Furthermore, the control group demonstrated a significantly greater improvement in VAS pain score compared to the hindfoot arthrodesis group. Walking speed, sit-to-stand time, and 4-square step test time were significantly improved for both groups at each postoperative time point; however, the hindfoot arthrodesis group completed these tests significantly slower than the control group. There was no significant difference in terms of talar component subsidence between the fusion (2.6 mm) and control groups (2.0 mm). The failure rate in the hindfoot fusion group (10.0%) was significantly higher than that in the control group (2.4%; p < 0.05). Conclusion: To our knowledge, this study represents the first series evaluating the clinical outcome of TARs performed with and without hindfoot fusion using implants available in the United States. At follow-up of 3.2 years, TAR performed with ipsilateral hindfoot arthrodesis resulted in significant improvements in pain and functional outcome; in contrast to prior studies, however, overall outcome was inferior to that of isolated TAR. Level of Evidence: Level II, prospective comparative series.

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“…2 While the current study validates the utility of CT scan interpretation of joint fusion among orthopaedic surgeons, several limitations need to be acknowledged. This is a purely retrospective, radiographic study, with no clinical correlation to identify what can be considered a successful outcome.…”

Section: Discussionmentioning

confidence: 88%

Reproducibility of Computed Tomography to Evaluate Ankle and Hindfoot Fusions

et al. 2014

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Comparison of Radiographs and CT Scans in the Prospective Evaluation of the Fusion of Hindfoot Arthrodesis

Abstract: We believe the progress of the fusion cannot be determined accurately from standard radiographs. CT scanning appears to be significantly more reliable. The concept of what constitutes an adequate fusion deserves more extensive study.

Cited by 133 publications

References 32 publications

Posterior Arthroscopic Subtalar Arthrodesis: Clinical and Radiologic Review of 19 Cases

Posterior Arthroscopic Subtalar Arthrodesis: Clinical and Radiologic Review of 19 Cases

Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis

Reproducibility of Computed Tomography to Evaluate Ankle and Hindfoot Fusions

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