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Updated: Oct 2, 2025

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Double Versus Triple Arthrodesis Fusion Rates: A Systematic Review.

Nicole K Cates1, Alissa Mayer2, Jonathan Tenley2

  • 1Fellowship Trained Foot and Ankle Surgeon, Hand & Microsurgery Medical Group, San Francisco, CA.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|February 28, 2022
PubMed
Summary
This summary is machine-generated.

Double arthrodesis offers comparable fusion rates and times to triple arthrodesis for hindfoot deformities. This systematic review suggests double arthrodesis is a suitable alternative, potentially reducing surgical risks and costs.

Keywords:
calcaneocuboid arthrodesishindfoot fusionposterior tibial tendon dysfunctionsubtalar arthrodesistalonavicular arthrodesis

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Reconstruction
  • Systematic Review and Meta-Analysis

Background:

  • Hindfoot arthrodesis is a common procedure for end-stage deformities like posterior tibial tendon dysfunction and osteoarthritis.
  • A debate exists regarding the optimal surgical approach: double versus triple arthrodesis.

Purpose of the Study:

  • To systematically review and compare fusion rates and time to fusion between double and triple hindfoot arthrodesis.

Main Methods:

  • A systematic review of 184 articles published between 2005 and 2017.
  • Inclusion of 13 eligible studies involving 343 extremities undergoing double or triple arthrodesis.

Main Results:

  • Overall fusion rate for double arthrodesis was 91.75% versus 92.86% for triple arthrodesis (p=0.8370).
  • Mean time to fusion was 17.96 weeks for double arthrodesis and 16.70 weeks for triple arthrodesis (p=0.8133).
  • Triple arthrodesis carries risks such as increased surgical time and wound complications.

Conclusions:

  • Double arthrodesis demonstrates nearly equivalent fusion rates and time to fusion compared to triple arthrodesis.
  • Double arthrodesis is recommended as an effective alternative, potentially offering advantages in surgical time and complication risks.