Long-Term Functional and Radiographic Outcomes of Untreated Tarsal Coalitions: A Community-Based Observational Study.

Area of Science:

• Orthopedics
• Radiology
• Podiatry

Background:

• The natural history and long-term outcomes of untreated tarsal coalitions are not well understood.
• Atypical biomechanics from limited hindfoot motion may lead to early degeneration, pain, or dysfunction.
• Data on nonoperatively managed asymptomatic tarsal coalitions is lacking.

Purpose of the Study:

• To determine the frequency of radiographically apparent tarsal coalitions in a general population.
• To observe the natural history of tarsal coalitions by comparing functional scores and osteoarthritis.
• To assess if coalition presence is associated with worsened outcomes or radiographic osteoarthritis.

Main Methods:

• Radiographs from a community-based study were reviewed for calcaneonavicular (CN) and talocalcaneal (TC) coalitions.
• Patient-reported outcomes (PROMIS, FAOS) and radiographic osteoarthritis were compared between coalition (C) and no coalition (NC) groups.
• Level III evidence was utilized.

Main Results:

• Radiographic coalitions were identified in 9.3% of feet (6.4% CN, 3.0% TC) among 299 participants.
• No significant differences in PROMIS or FAOS scores were found between NC and C groups.
• No significant association between coalition presence and radiographic osteoarthritis; a modest association between CN coalitions and talonavicular osteoarthritis was noted. TC coalitions showed marginally worse FAOS subscores but minimal dysfunction.

Conclusions:

• Subclinical tarsal coalitions show limited association with osteoarthritis or significant foot dysfunction.
• Talocalcaneal (TC) coalitions may be linked to slightly lower lifetime functional scores.
• Non-operative management is recommended for asymptomatic tarsal coalitions, with findings aiding patient counseling.