Clinical and Radiological Mid- to Long-term Results Following Triple Arthrodesis

Triple arthrodesis (TA) is a common procedure for stabilization of painful and unstable hind foot deformities. The aim of the study was to analyze postoperative changes in function and pain following isolated TA based on clinical outcomes, radiological findings, and pain scores. The study also considered economic aspects, such as the inability to work, before and after surgery.

This was a single-center retrospective study, with a mean follow-up of 7.8 (range=2.9-12.6) years, of isolated triple fusions was performed. Short-Form 36 (SF-36), Foot Function Index (FFI), American Orthopedic Foot and Ankle Society Score (AOFAS) were analyzed. Clinical examination and standardized radiographs pre- and post-surgery were evaluated.

All 16 patients were very satisfied with the outcome after TA. In patients with secondary arthrosis of the ankle joint, AOFAS scores were significantly lower (p=0.012), whereas arthrosis in tarsal and tarsometatarsal joints did not affect the score. Body mass index (BMI) was associated with lower AOFAS, FFI-pain, FFI-function and increased hindfoot valgus. The non-union rate was approximately 11%.

TA leads to good clinical and radiological outcomes. None of the study participants reported a deterioration in their quality of life after TA. Two thirds of the patients reported significant limitations when walking on uneven ground. More than half of the feet developed secondary arthrosis of the tarsal joints and 44% of the ankle joint.