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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Computer-assisted surgery for subtalar arthrodesis. A study in cadavers.

Mark Easley1, Bavornrit Chuckpaiwong, Nathan Cooperman

  • 1Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27704, USA. easle004@mc.duke.edu

The Journal of Bone and Joint Surgery. American Volume
|August 5, 2008
PubMed
Summary

Computer-assisted subtalar arthrodesis showed equivalent screw placement accuracy to conventional methods. This technique reduced guidewire passes and fluoroscopy time, but increased operative time for experienced surgeons.

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Area of Science:

  • Orthopaedic Surgery
  • Medical Technology
  • Surgical Navigation

Background:

  • Computer navigation is gaining traction in orthopaedic surgery.
  • However, its application in foot and ankle procedures remains under-investigated.
  • This study addresses this gap by evaluating computer-assisted subtalar arthrodesis.

Purpose of the Study:

  • To compare the efficacy of computer-assisted subtalar arthrodesis versus conventional fluoroscopically-guided methods.
  • To assess the impact of surgeon experience on both techniques.
  • To evaluate key performance metrics including accuracy, time, and safety.

Main Methods:

  • Subtalar arthrodesis performed on 36 cadaver lower extremities.
  • Procedures were conducted by experienced and inexperienced surgeons, with and without computer navigation.

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  • Key outcomes measured: guidewire placement, fluoroscopy time, operative time, screw accuracy, and adverse events.

    • Main Results:

    • Computer assistance significantly decreased guidewire passes for both surgeon groups (p < 0.001).
    • Fluoroscopic time was reduced with computer assistance (p < 0.001).
    • Screw placement accuracy and adverse events were comparable between conventional and computer-assisted methods.

    Conclusions:

    • Computer-assisted subtalar arthrodesis achieves accuracy comparable to conventional techniques.
    • It offers benefits in reducing guidewire passes and fluoroscopy time.
    • Operative time increased for experienced surgeons using computer assistance, but not for inexperienced ones.