title: Arthroscopic Medial Approach for Modified Double Arthrodesis of the Foot.
abstract: The single medial incision subtalar joint and talonavicular joint arthrodesis has been shown to be a useful alternative for the correction of hindfoot valgus deformity. We describe an arthroscopic method of joint preparation using this approach. The present case report included 6 consecutive patients aged 35 to 72 (mean ± standard deviation 55.8 ± 15.54) years (4 males [66.7%] and 2 females [33.3%]), who had undergone the medial approach for modified double arthrodesis of the foot. Of the 6 patients, 3 (50.0%) had undergone arthroscopic joint preparation and 3 (50.0%) traditional (manual) joint preparation. Osteobiologic agents were used in all patients. We found a shorter tourniquet time for the patients who had undergone an arthroscopic approach, with a mean of 110 ± 7.21 minutes, compared with a traditional joint preparation, with a mean of 121.3 ± 8.08 minutes. We also found a shorter time to radiographic union in the patients who had undergone an arthroscopic approach, all of whom showed signs of union at 6 weeks. Only 2 of the 3 patients in the traditional joint preparation group had achieved union at a mean of 10 ± 2.83 weeks, with 1 case resulting in nonunion. This technique could be a viable alternative to traditional methods of joint preparation by decreasing the operative time and improving the union rates.
authors.affiliation: Resident Physician, Kaiser Permanente South Bay Consortium, Santa Clara, CA. Electronic address: ericfshi@gmail.com.
authors.forename: Eric
authors.initials: E
authors.lastname: Shi
authors.affiliation: Attending Physician, Department of Orthopaedic Surgery, The Permanente Medical Group, San Leandro, CA.
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Weinraub
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D001863:Bone Screws; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D056888:Patient Positioning / Q000379:methods; D011182:Postoperative Care; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D013380:Subtalar Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D013640:Tarsal Joints / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
keywords: arthroscopy; flatfoot; hindfoot; pes planus; surgery; triple arthrodesis