Double Versus Triple Arthrodesis Fusion Rates: A Systematic Review

Cates, Nicole K.; Mayer, Alissa; Tenley, Jonathan; Wynes, Jacob; Tefera, Eshetu; Steinberg, John S.; Kim, Paul J.; Weinraub, Glenn M.

doi:10.1053/j.jfas.2022.01.012

Cited by 3 publications

(3 citation statements)

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“…9,23,25,30,34 A recent systematic review reported plain radiograph confirmed fusion rates of 91.8% and 92.9% for double and triple arthrodesis, respectively. 7 Interestingly, in contrast to the same study listed above, this systematic review found that TNJ joints had the highest CT-confirmed union rates at 90% whereas they found TNJ joints had the worst fusion among joints at 79.6%. 7 CT provides the practitioner an indepth 3-dimensional analysis of the fused joint allowing for All patients 1,3-5,10-14, [16][17][18][19][20]24,26,28,31,33,35,37,39,41,42 1015 0.79 0.70 0.88 11.99 -91.81 All joints 1,[3][4][5][9][10][11]13,14,16,18,19,[26][27][28]31,35,37,41,42 1301 0.83 0.73 0.93 9.00 -100.07 Ankles 3,5,17,18,32,…”

Section: Discussioncontrasting

confidence: 61%

“… 9 , 23 , 25 , 30 , 34 A recent systematic review reported plain radiograph confirmed fusion rates of 91.8% and 92.9% for double and triple arthrodesis, respectively. 7 Interestingly, in contrast to the same study listed above, this systematic review found that TNJ joints had the highest CT-confirmed union rates at 90% whereas they found TNJ joints had the worst fusion among joints at 79.6%. 7 CT provides the practitioner an in-depth 3-dimensional analysis of the fused joint allowing for better evaluation of the success of the procedure.…”

Section: Discussioncontrasting

confidence: 61%

“… 7 Interestingly, in contrast to the same study listed above, this systematic review found that TNJ joints had the highest CT-confirmed union rates at 90% whereas they found TNJ joints had the worst fusion among joints at 79.6%. 7 CT provides the practitioner an in-depth 3-dimensional analysis of the fused joint allowing for better evaluation of the success of the procedure. With a total of 21.3% of the surgical population in this cohort not going on to union, it brings pause to the conversation around informed consent and provides patients and practitioners with accurate information regarding the risks of proposed procedures.…”

Section: Discussioncontrasting

confidence: 61%

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CT-Verified Union Rate Following Arthrodesis of Ankle, Hindfoot, or Midfoot: A Systematic Review

et al. 2023

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Background: Ankle, hindfoot, and midfoot arthrodesis surgeries are standard procedures performed in orthopaedics to treat pain and functional disabilities. Although fusions can effectively improve pain and quality of life, nonunions remain a significant concern for surgeons. With the increased availability of computed tomography (CT), more surgeons rely on this modality for increased accuracy in determining whether a fusion was successful. The objective of this study was to report the rates of CT-confirmed fusion following ankle, hindfoot, or midfoot arthrodesis. Methods: A systematic review was performed using EMBASE, Medline, and Cochrane central register from January 2000 to March 2020. Inclusion criteria included studies with adults (<18 years) that received 1 or multiple fusions of the ankle, hindfoot, or midfoot. At least 75% of the study cohort must have been evaluated by CT postoperatively. Basic information was collected, including journal, author, year published, and level of evidence. Other specific information was collected, including patient risk factors, fusion site, surgical technique and fixation, adjuncts, union rates, criteria for successful fusion (%), and time of CT. Once data were collected, a descriptive and comparative analysis was performed. Results: Included studies (26, n = 1300) had an overall CT-confirmed fusion rate of 78.7% (69.6-87.7). Individual joints had an overall fusion rate of 83.0% (73-92.9). The highest rate of union was in the talonavicular joint (TNJ). Conclusion: These values are lower than previous studies, which found the same procedures to have greater than 90% fusion rates. With these updated figures, as confirmed by CT, surgeons will have better information for clinical decision making and when having informed consent conversations.

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Section: Discussioncontrasting

confidence: 61%

“… 9 , 23 , 25 , 30 , 34 A recent systematic review reported plain radiograph confirmed fusion rates of 91.8% and 92.9% for double and triple arthrodesis, respectively. 7 Interestingly, in contrast to the same study listed above, this systematic review found that TNJ joints had the highest CT-confirmed union rates at 90% whereas they found TNJ joints had the worst fusion among joints at 79.6%. 7 CT provides the practitioner an in-depth 3-dimensional analysis of the fused joint allowing for better evaluation of the success of the procedure.…”

Section: Discussioncontrasting

confidence: 61%