Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up.

BACKGROUND: Isolated subtalar arthrodesis is the treatment of choice for several conditions -mostly subtalar arthritis, tarsal coalition and posterior tibial tendon dysfunction- unresponsive to conservative treatment. Arthroscopic procedures are an interesting recent alternative, less invasive than conventional open techniques. Posterior arthroscopy, in prone position, could be more advantageous than the conventional lateral and/or anterior approach.

PATIENTS AND METHODS: Ten cases, from 20 to 59-years-old, were prospectively followed up for minimum of one-year (range 12 to 31 months). Arthritis and tarsal coalition were the most common indications.

RESULTS: Fusion was observed in all cases at a maximum of nine weeks. Mean average AOFAS score improved from 47 to 78. No complications were noted related to the technique. Only two patients, operated for a symptomatic subtalar coalition, complained of some residual pain due to a lateral submalleolar impingement. Interest of preservation of vascular talar supply and bone grafting are discussed.

CONCLUSION: The good results using this innovative technique are encouraging. Long-term randomized studies remain necessary to confirm the reliability of the procedure in these different indications, and the type of bone graft to favour, if really needed.

LEVEL OF EVIDENCE: Level IV therapeutic study.