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Journal of the American Podiatric... Mar 2021A survey of pathology present in the subtalar joint by means of subtalar arthroscopy with anterolateral and middle portals has not been extensively explored in the... (Review)
Review
BACKGROUND
A survey of pathology present in the subtalar joint by means of subtalar arthroscopy with anterolateral and middle portals has not been extensively explored in the literature. The focus of this study was to identify pathology in the subtalar joint with subtalar joint arthroscopy using this approach. We also compared these arthroscopic findings with those reported in the literature.
METHODS
We performed a retrospective review of 49 consecutive patients who had undergone 53 subtalar arthroscopic procedures. Data were obtained from intraoperative arthroscopic findings that were documented in the operative note or with arthroscopic photography. Additional procedures, including ankle arthroscopy, lateral ankle stabilization, and peroneal tendon repair, were recorded. Descriptive statistics were calculated and reported.
RESULTS
Subtalar arthroscopic examination revealed that all of the patients had intra-articular synovitis or adhesions present. Twenty-two procedures (42%) demonstrated subtalar joint instability, seven (13%) revealed chondromalacia, and one (2%) had an exostosis present. These observations are consistent with other reported findings in the literature.
CONCLUSIONS
This study found that the subtalar joint was most often affected by synovitis, adhesions, and instability in patients with symptomatic pathologies requiring subtalar arthroscopy. There was a relatively low incidence of chondromalacia or exostosis formation in the survey.
Topics: Ankle Joint; Arthroscopy; Bone Neoplasms; Humans; Retrospective Studies; Subtalar Joint
PubMed: 31549854
DOI: 10.7547/19-071 -
Foot and Ankle Clinics Jun 2015Imaging of the subtalar joint can be challenging because of its complex planar anatomy. This article reviews the anatomy and common anatomic variants as seen with... (Review)
Review
Imaging of the subtalar joint can be challenging because of its complex planar anatomy. This article reviews the anatomy and common anatomic variants as seen with different imaging techniques. Although radiography remains the initial mode of imaging, computed tomography and MRI are frequently needed to better delineate the joint anatomy and improve the sensitivity and the specificity of detection of joint pathology. A short review of arthrographic techniques and various examples of imaging of common pathology involving this joint are also included.
Topics: Arthrography; Fluoroscopy; Humans; Imaging, Three-Dimensional; Joint Diseases; Ligaments, Articular; Magnetic Resonance Imaging; Subtalar Joint; Tomography, X-Ray Computed
PubMed: 26043240
DOI: 10.1016/j.fcl.2015.02.009 -
Foot (Edinburgh, Scotland) Dec 2014The subtalar joint is important for gait and function of the foot and ankle. With few external landmarks, the joint is difficult to conceptualize and study in vivo.... (Review)
Review
The subtalar joint is important for gait and function of the foot and ankle. With few external landmarks, the joint is difficult to conceptualize and study in vivo. There have been several functional representations put forth in the literature which can be combined to give a broader understanding of the overall function and mechanics of the subtalar joint. This understanding is clinically important when considering the impact that disease has on the subtalar joint as well as how treatment of the subtalar joint impacts on the surrounding structures.
Topics: Biomechanical Phenomena; Gait; Humans; Range of Motion, Articular; Subtalar Joint; Walking
PubMed: 25175840
DOI: 10.1016/j.foot.2014.06.003 -
Foot and Ankle Clinics Mar 2017Peripheral talus fractures include injuries to the lateral process, posteromedial talar body, and talar head. These injuries are rare and are often missed. Nonunion with... (Review)
Review
Peripheral talus fractures include injuries to the lateral process, posteromedial talar body, and talar head. These injuries are rare and are often missed. Nonunion with conservative treatment is high and excision can lead to joint instability, rapid arthrosis, and earlier need for arthrodesis. Open reduction internal fixation of most peripheral talus fractures is critical to achieving a good outcome. Open reduction leads to more rapid union and ability to mobilize the ankle and subtalar joints, quicker revascularization of the talus, and lower rates of arthrosis. Surgical treatment can lead to substantial functional improvement and a slowing of the degenerative process.
Topics: Ankle Fractures; Ankle Joint; Fracture Fixation, Internal; Fractures, Bone; Humans; Open Fracture Reduction; Subtalar Joint; Talus
PubMed: 28167062
DOI: 10.1016/j.fcl.2016.09.012 -
Foot and Ankle Clinics Sep 2018Traumatic injury to the subtalar joint occurs during subtalar dislocations, talar and calcaneal fractures, and fracture-dislocations. After closed reduction of subtalar... (Review)
Review
Traumatic injury to the subtalar joint occurs during subtalar dislocations, talar and calcaneal fractures, and fracture-dislocations. After closed reduction of subtalar dislocations, peripheral talar or calcaneal fractures need to be ruled out by computed tomography scanning. In fractures and fracture-dislocations of the talus and calcaneus involving the subtalar joint, anatomic reconstruction of joint congruity is essential for functional rehabilitation. Failure to anatomically reduce the subtalar joint potentially leads to chronic instability, subtalar arthritis and posttraumatic hindfoot deformity. Despite adequate management, subtalar arthritis may develop as a result of primary cartilage damage at the time of injury.
Topics: Arthritis; Calcaneus; Fracture Dislocation; Fractures, Bone; Humans; Intra-Articular Fractures; Joint Dislocations; Subtalar Joint; Talus
PubMed: 30097079
DOI: 10.1016/j.fcl.2018.04.004 -
Foot and Ankle Clinics Mar 2024The debate between ankle arthrodesis and total ankle replacement for patients with end-stage arthritis of the ankle joint is an ongoing topic in orthopedic surgery.... (Review)
Review
The debate between ankle arthrodesis and total ankle replacement for patients with end-stage arthritis of the ankle joint is an ongoing topic in orthopedic surgery. Ankle arthrodesis, or fusion, has been the traditional treatment for ankle arthritis. It involves fusing the bones of the ankle joint together, eliminating the joint and creating a solid bony union. Arthrodesis is effective in reducing pain in the ankle, but it results in a loss of ankle motion. This can increase the load on adjacent joints, such as the subtalar joint, which may lead to accelerated degeneration and arthritis in those joints over time.
Topics: Humans; Arthroplasty, Replacement, Ankle; Treatment Outcome; Ankle Joint; Ankle; Arthritis; Subtalar Joint; Arthrodesis; Retrospective Studies
PubMed: 38309799
DOI: 10.1016/j.fcl.2023.08.007 -
Foot and Ankle Clinics Sep 2018Surgical access to the subtalar joint is required in a plethora of pathologic conditions of the hindfoot. The conventional lateral approach can give excellent access to... (Review)
Review
Surgical access to the subtalar joint is required in a plethora of pathologic conditions of the hindfoot. The conventional lateral approach can give excellent access to subtalar joint; however, in hindfoot valgus deformities, there can be unacceptable risks of wound problems and incomplete deformity corrections. The medial approach offers good access to the subtalar joint with an increasing evidence base for its use, especially with double fusions in pes planus deformities. The authors review the current evidence in the use of the medial approach for the subtalar joint.
Topics: Arthrodesis; Arthroscopy; Humans; Ligaments, Articular; Subtalar Joint
PubMed: 30097084
DOI: 10.1016/j.fcl.2018.04.006 -
Foot and Ankle Clinics Jun 2023Acute and chronic subtalar instability and commonly coexistent with other hindfoot pathology but can be difficult to diagnose. A high degree of clinical suspicion is... (Review)
Review
Acute and chronic subtalar instability and commonly coexistent with other hindfoot pathology but can be difficult to diagnose. A high degree of clinical suspicion is required as most imaging modalities and clinical maneuvers are poor at detecting isolated subtalar instability. The initial treatment is similar to ankle instability, and a wide variety of operative interventions have been presented in the literature for persistent instability. Outcomes are variable and limited.
Topics: Humans; Joint Instability; Subtalar Joint; Foot; Ankle Joint
PubMed: 37137632
DOI: 10.1016/j.fcl.2022.12.008 -
Foot and Ankle Clinics Jun 2015Tarsal coalitions, while relatively uncommon, are typically identified in adult patients during an evaluation for ankle instability, sinus tarsus pain, and/or pes... (Review)
Review
Tarsal coalitions, while relatively uncommon, are typically identified in adult patients during an evaluation for ankle instability, sinus tarsus pain, and/or pes planovalgus. The true incidence of tarsal coalition is unknown with estimates ranging from 1% to 12% of the overall population. The most common area of involvement of the subtalar joint is the middle facet, and heightened awareness should be present in adult patients with limited motion of the subtalar joint. Standard radiographic imaging, to include a Harris heel view, is recommended initially, although computerized tomography scan and MRI are often necessary to confirm the diagnosis.
Topics: Adult; Age Factors; Foot Deformities; Humans; Subtalar Joint
PubMed: 26043244
DOI: 10.1016/j.fcl.2015.02.010 -
Foot & Ankle International Jan 2022Advances in foot and ankle arthroscopy over the last 2 decades have allowed for subtalar joint arthrodesis to be performed arthroscopically. The potential advantages of...
BACKGROUND
Advances in foot and ankle arthroscopy over the last 2 decades have allowed for subtalar joint arthrodesis to be performed arthroscopically. The potential advantages of the arthroscopic technique include higher fusion rates, lower complications, reduced perioperative morbidity, and accelerated rehabilitation. Arthroscopic arthrodesis may, however, not be appropriate in the setting of complex deformity correction or the need for other open procedures.
METHODS
Surgical techniques of arthroscopic subtalar joint arthrodesis are described. Outcomes and complications associated with these procedures are presented, based on a comprehensive literature review. Thirteen Level IV studies of moderate quality were included.
RESULTS AND CONCLUSION
Excellent arthrodesis union rates were achieved (average 96%, range 86%-100%), at a weighted average union time of 8.8 weeks (95% confidence interval 7.9-9.7). The overall complication rate was 21% (87/415 feet; range 10%-36.4%). Metal irritation was the most common complication (11.2%), followed by nerve injury (4.2%) and infection (0.9%). Similar fusion rates have been reported when comparing arthroscopic and open arthrodesis. Complication rates are also similar, excerpt for infection, which may be lower with arthroscopy. Three different approaches were used to access the subtalar joint with similar union and complication rates. There was no evidence that the use of bone graft or more than 1 screw improved outcomes. The superiority of arthroscopic subtalar fusion over open techniques cannot be demonstrated by the available studies.
LEVEL OF EVIDENCE
Level IV, case series.
Topics: Ankle Joint; Arthrodesis; Arthroscopy; Humans; Retrospective Studies; Subtalar Joint; Treatment Outcome
PubMed: 34549616
DOI: 10.1177/10711007211035397