Failure of triple arthrodesis.

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery

Background:

• Triple arthrodesis is a salvage procedure for severe foot deformities like pes planovalgus and cavovarus.
• Few operative alternatives exist, with subtalar resurfacing prostheses abandoned and tendon transfers/osteotomies not always feasible.

Purpose of the Study:

• To evaluate the long-term outcomes and patient satisfaction following triple arthrodesis.
• To assess the durability of triple arthrodesis as a salvage procedure for complex foot deformities.

Main Methods:

• Review of cases undergoing triple arthrodesis, with a focus on long-term follow-up (44 years).
• Analysis of patient satisfaction, functional status, and pain levels over time.
• Discussion of surgical approaches, including single anterolateral and two-incision techniques, and the role of internal fixation.

Main Results:

• 95% of surviving patients reported satisfaction at 44 years post-fusion.
• Deterioration in function and some increase in pain were observed over time.
• Modern techniques, including the two-incision approach and rigid internal fixation, have improved reliability and reduced complication rates.

Conclusions:

• Triple arthrodesis remains a viable salvage option for severe foot deformities, offering high long-term patient satisfaction.
• Deterioration over decades is an expected consequence of this salvage procedure.
• Careful patient selection and meticulous surgical technique are crucial for optimal outcomes.