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Subtalar Arthrodesis Union Rates With and Without Adjacent Ankle Arthrodesis
Toby Jennison1, James Dalgleish1, Suhib Taher1
1Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.
Foot & Ankle International
|July 23, 2022
Summary
Subtalar arthrodesis union rates are significantly lower in patients with prior ankle fusion. Adjacent ankle arthrodesis is a key risk factor for subtalar nonunion, necessitating careful patient counseling.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Surgery
Background:
- Subtalar arthritis is commonly treated with subtalar arthrodesis.
- Preexisting adjacent joint arthrodesis may increase subtalar nonunion rates.
Purpose of the Study:
- To compare subtalar arthrodesis union rates in patients with native tibiotalar joints versus prior tibiotalar arthrodesis.
- To identify risk factors associated with subtalar nonunion.
Main Methods:
- Retrospective cohort study of 71 patients undergoing subtalar arthrodesis (2010-2020).
- Union assessed via radiographs and clinical symptoms; CT used if uncertain.
- Logistic regression analyzed risk factors for nonunion.
Main Results:
- Subtalar arthrodesis union rate was 44.4% with prior ankle arthrodesis vs. 86.8% without (P < .001).
- Adjacent ankle arthrodesis was the sole significant risk factor for nonunion (OR 4.90).
- Revision rates were higher with prior ankle arthrodesis (44.4% vs. 9.4%, P = .001).
Conclusions:
- Subtalar arthrodesis in patients with prior ankle arthrodesis has a substantially higher nonunion risk.
- Patients with a previously fused ankle require counseling regarding elevated nonunion and revision surgery risks.
