Posterior Arthroscopic Subtalar Arthrodesis

Bevernage, Bernhard Devos; Goubau, Laurent; Gombault, Vincent; Maldague, Pierre; Leemrijse, Thibaut

doi:10.2106/jbjs.st.o.00021

Cited by 7 publications

(28 citation statements)

References 13 publications

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“…Fusion of the subtalar joint was observed in all 8 patients by 12 weeks and in 5 of them as soon as 8 weeks postoperatively (mean, 9.5 [8][9][10][11][12] weeks).…”

Section: Resultsmentioning

confidence: 93%

“…24,29,37 The arthroscopic approach has been successfully employed for subtalar arthrodesis, as consecutive reports in the literature confirm high rates of union, rare postoperative complications and high patient satisfaction, by reducing postoperative pain and allowing a quicker return to work and recreational sports. 1,3,4,8,12,18,21,24,29,30,32,33,36 However, reports on the arthroscopic approach for subtalar joint arthrodesis for middle facet talocalcaneal coalition are scarce and are often included in larger series reporting on different conditions, the most common being posttraumatic subtalar osteoarthritis or inflammatory conditions, such as rheumatoid or psoriatic arthritis. 1,3,4,8,18,21,32,33,37 The aim of this study was to determine both clinical and radiographic outcomes of posterior arthroscopic subtalar arthrodesis (PASTA) 3 for adult patients presenting with symptomatic medial facet talocalcaneal coalition and normal hindfoot alignment.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of Posterior Arthroscopic Subtalar Arthrodesis for Medial Facet Talocalcaneal Coalition

Saraiva

Knupp

Rodrigues³

et al. 2021

Foot Ankle Int.

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Background: Medial facet talocalcaneal coalition can be a painful condition. This study aimed to determine clinical and radiographic outcomes of posterior arthroscopic subtalar arthrodesis (PASTA) for adult patients presenting with symptomatic medial facet talocalcaneal coalition and normal hindfoot alignment, with a minimal follow-up of 18 months. Methods: Between June 2017 and July 2019, this procedure was performed on 8 feet (8 patients; mean age, 55 [42-70] years; mean BMI, 29.8 [24.4-45.0] kg/m2). Clinical assessment was performed using Visual Analog Scale for Pain (VAS-P), Foot and Ankle Outcome Score (FAOS) and the 36-Item Short-Form Health Survey (SF-36). Patient satisfaction was assessed at the last available follow-up as “very satisfied”, “satisfied” or “unsatisfied”. Radiographic analysis was performed using plain radiography, computed tomography (CT) scan and magnetic resonance imaging (MRI). The primary outcome was to determine both clinical and radiographic outcomes. Results: The mean follow-up was 25.1 (18.2-34.2) months. The authors found statistically significant improvement on all clinical scores (VASP-P, FAOS and SF-36). They registered 6 “very satisfied” patients, 2 “satisfied” patients and no “unsatisfied” patient. Fusion of the subtalar joint was observed in all patients by 12 weeks and in 5 of them as soon as 8 weeks postoperatively (mean, 9.5 [8-12] weeks). There were no cases of delayed fusion or nonunion of the subtalar joint, superficial or deep infection, neurovascular damage, thromboembolic event, screw breakage, need for hardware removal or revision surgery. Conclusion: This study found that PASTA is a safe and reliable technique for adult patients presenting with symptomatic medial facet talocalcaneal coalition and normal hindfoot alignment, demonstrating and maintaining clinical improvement at an average follow-up of 2 years. Level of Evidence: Level IV, case series.

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“…Fusion of the subtalar joint was observed in all 8 patients by 12 weeks and in 5 of them as soon as 8 weeks postoperatively (mean, 9.5 [8][9][10][11][12] weeks).…”

Section: Resultsmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Outcomes of Posterior Arthroscopic Subtalar Arthrodesis for Medial Facet Talocalcaneal Coalition

Saraiva

Knupp

Rodrigues³

et al. 2021

Foot Ankle Int.

View full text Add to dashboard Cite

show abstract

“…All selected studies were identified using the literature search strategy, as the review of reference sections did not identify additional articles for inclusion. Overall, 8 studies 5 , 9 , 12 , 18 , 21 , 22 , 24 , 31 examined prone patients with 2 posterior portals (n = 111; 22.9%), 7 articles 4 , 11 , 13 , 16 , 27 , 30 , 35 evaluated lateral portals in the supine or lateral position (n = 182; 37.6%), and 5 studies 2 , 3 , 6 , 26 , 34 examined patients in the prone position with 3 portals (n = 191; 39.5%). The mean MCMS of included studies was found to be 38.4 (range, 10-63) ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Do Patient Positioning and Portal Placement for Arthroscopic Subtalar Arthrodesis Matter?

Shamrock

Amendola

Glass

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Arthroscopic subtalar arthrodesis was first described over 2 decades ago and originally performed in the lateral decubitus or supine position using anterolateral and posterolateral portals situated about the fibula. More recently, several authors have advocated for prone positioning utilizing posteromedial and posterolateral portals with an optional accessory lateral portal. To date, a comparison of these techniques has been limited. Purpose: To determine the effect of patient positioning and portal placement on complication rates after arthroscopic subtalar arthrodesis. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Patients were placed into 1 of 3 groups: the lateral group if they were positioned lateral or supine with lateral-based portals; the 2-portal prone group if they were positioned prone with posteromedial and posterolateral portals; or the 3-portal prone group if posteromedial, posterolateral, and accessory lateral portals were utilized in the prone position. Inverse variance–weighted fixed-effects models were used to evaluate pooled estimates. Results: A total of 20 studies examining 484 feet in 468 patients with a mean follow-up of 36.1 months were included for analysis. Overall, 8 studies examined patients in the prone position with 2 posterior portals (n = 111; 22.9%), 7 articles evaluated lateral portals (n = 182; 37.6%), and 5 studies examined patients in the prone position with 3 portals (n = 191; 39.5%). The total complication rate was similar ( P = .620) between the 2-portal prone (18.9%), 3-portal prone (17.8%), and lateral (17.6%) groups. There was no difference observed in the rate of complications secondary to portal placement ( P ≥ .334), rate of painful hardware ( P ≥ .497), and rate of repeat surgery ( P ≥ .304). The 2-portal prone group had a significantly higher rate of nonunion than the lateral group (8.1% vs 1.1%, respectively; P = .020) but not the 3-portal prone group (5.8%; P = .198). Conclusion: The current study demonstrated a higher rate of nonunion following arthroscopic subtalar arthrodesis with prone patient positioning using posteromedial and posterolateral portals without an accessory lateral portal.

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“…In our open group patients, the mean improvements were 23.4 and 28.8 points in the FAAM ADL and Sports scores, respectively; 13.9 and 16.0 points in the SF-36 PCS and MCS scores, respectively; and 8.0/10 in the VAS score at the final postoperative visit. Furthermore, studies have reported that the mean improvements following the PASTA technique were 31 to 75 points in the AOFAS hindfoot score 2,3,10,19,24 ; 17.0 and 24.5 points in the SF-36 MCS and PCS scores, respectively 31 ; and 5.1 to 6.8/10 in the VAS score. 24,31 Similarly, in our PASTA group patients, the mean improvements were 20.5 and 18.8 points in the FAAM ADL and Sports scores, respectively; 20.9 and 23.0 points in the SF-36 PCS and MCS scores, respectively; and 8.2/10 in the VAS score at the final postoperative visit.…”

Section: Discussionmentioning

confidence: 99%

“…12,34 Posterior arthroscopic subtalar arthrodesis (PASTA), which has recently been reported (in 2007), 3 has gained increasing popularity over the past decade due to a shorter recovery time, better cosmesis, and fewer complications. 2,3,10,19,20,24,31 However, there is a paucity of evidence in the current literature comparing the outcomes and complications between the open and PASTA techniques.…”

mentioning

confidence: 99%

Outcomes and Complications of Open vs Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Controlled Multicenter Study

et al. 2021

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Background: Open subtalar arthrodesis is the standard treatment for subtalar arthritis. Posterior arthroscopic subtalar arthrodesis (PASTA) has recently gained increasing popularity due to a shorter recovery time and better cosmesis. However, studies comparing outcomes and complications between these 2 techniques are limited. Methods: In total, 56 patients with subtalar joint arthritis were prospectively randomized to 2 parallel groups to receive either PASTA (n = 28 patients) or open subtalar arthrodesis (n = 28 patients). The minimum follow-up period was 12 months. Primary outcome was union rate confirmed on postoperative computed tomography (CT) scan. Secondary outcomes were union time; visual analog scale (VAS), Short Form–36 (SF-36), and Foot and Ankle Ability Measure (FAAM) scores; tourniquet time; and complications. Results: Union time (9.4 vs 12.8 weeks) and recovery time (time to return to activities of daily living [8.4 vs 10.8 weeks], work [10.6 vs 12.9 weeks], and sports [24.9 vs 32.7 weeks]) were significantly shorter with PASTA than with the open technique ( P < .05 all). Both techniques led to significant improvements in all functional outcomes (FAAM, SF-36, and VAS scores; P < .01 all); however, there was no significant difference between the techniques in these outcomes ( P > .05 all). Other outcomes, including tourniquet time (55.8 vs 67.2 min), union rate (96.3% vs 100%), and complication rate, were not significantly different between the techniques. Conclusion: Both open and PASTA techniques led to significant improvements in pain and function in patients with isolated subtalar joint arthritis. Although short-term functional outcomes and complication rates were not significantly different between the techniques, the PASTA technique was better at shortening the union and recovery times. Level of Evidence: Level I, prospective multicenter randomized controlled trial.

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Posterior Arthroscopic Subtalar Arthrodesis

Cited by 7 publications

References 13 publications

Outcomes of Posterior Arthroscopic Subtalar Arthrodesis for Medial Facet Talocalcaneal Coalition

Outcomes of Posterior Arthroscopic Subtalar Arthrodesis for Medial Facet Talocalcaneal Coalition

Do Patient Positioning and Portal Placement for Arthroscopic Subtalar Arthrodesis Matter?

Outcomes and Complications of Open vs Posterior Arthroscopic Subtalar Arthrodesis: A Prospective Randomized Controlled Multicenter Study

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