Subtalar and talonavicular arthrodesis under lateral arthroscopy

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Foot and Ankle Reconstruction

Background:

• Open hindfoot surgery, particularly for subtalar and talonavicular fusions, is associated with significant complication rates, including infection and soft tissue issues.
• Arthroscopic subtalar arthrodesis has demonstrated reduced complications and high fusion rates (>90%).
• The application of arthroscopy for talonavicular arthrodesis remains less explored.

Purpose of the Study:

• To describe a standardized arthroscopic technique for combined subtalar and talonavicular arthrodesis.
• To evaluate the feasibility and potential benefits of arthroscopic hindfoot fusion.
• To present a minimally invasive alternative to open procedures for complex hindfoot fusions.

Main Methods:

• A novel arthroscopic technique utilizing two lateral portals around the sinus tarsi for access.
• Detailed description of the surgical steps for both subtalar and talonavicular joint preparation and fusion.
• Intraoperative visualization and instrumentation specific to arthroscopic hindfoot surgery.

Main Results:

• The described arthroscopic approach allows for visualization and fusion of both the subtalar and talonavicular joints.
• This technique aims to minimize the soft tissue disruption inherent in open surgery.
• Expected outcome is a reduction in complication rates compared to traditional open hindfoot fusions, while maintaining high fusion efficacy.

Conclusions:

• Arthroscopic subtalar and talonavicular arthrodesis is a viable technique for hindfoot reconstruction.
• This minimally invasive method holds promise for reducing surgical site complications.
• Further studies are warranted to compare outcomes with open arthrodesis in larger patient cohorts.