Effectiveness of arthroscopic debridement and release for post-traumatic arthritis of subtalar joint_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 WEIMin , LIUYang , WEIYu

Department of Orthopaedics, the Chinese PLA General Hospital, Beijing, 100853, P.R.China;

Corresponding author：

WEIMin, Email: weim301gk@sina.com

Keywords：

Subtalar joint; post-traumatic arthritis; arthroscopy

DOI：

10.7507/1002-1892.201609054

Video：

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Objective To evaluate the effectiveness of arthroscopic debridement and release for post-traumatic arthritis of subtalar joint. Methods Between January 2011 and December 2014, 14 cases of post-traumatic arthritis of the subtalar joint underwent arthroscopic debridement and release, and the clinical data were retrospectively analyzed. All patients were male, aged 42 years on average (range, 32-62 years). Calcaneus fracture was caused by falling from height; 8 cases received conservative treatment and the other 6 cases received open reduction and internal fixation. The mean interval from injury to operation was 3.4 years (range, 2-7 years). The arthroscopic debridement and release were performed through lateral portals. The injury degree of articular cartilage was classified as grade 3 in 4 cases and grade 4 in 10 cases based on Outerbridge rating. The degree of pain was assessed by visual analogue scale (VAS) and the function of joint was assessed by the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle Hindfoot Scale. Results All incisions healed by first intention and no complication occurred. The follow-up time was 18 months. Pain was relieved obviously; VAS was significantly decreased to postoperative 3.8±0.9 at 18 months from preoperative 7.7±1.2 (t=9.728,P=0.000), and AOFAS Ankle Hindfoot Scale was significantly increased to postoperative 59.1±8.8 from preoperative 37.6±8.2 (t=6.688,P=0.000). During follow-up, no patient was given arthrodesis and no worsened sign was found on the postoperative CT and MRI. Conclusion Arthroscopic debridement and release for post-traumatic arthritis of the subtalar joint can relieve clinical symptoms and delay subtalar arthrodesis.

Citation： WEIMin, LIUYang, WEIYu. Effectiveness of arthroscopic debridement and release for post-traumatic arthritis of subtalar joint. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(2): 150-154. doi: 10.7507/1002-1892.201609054 Copy

1.	Stapleton JJ, Zgonis T. Surgical treatment of intra-articular calcaneal fractures. Clin Podiatr Med Surg, 2014, 31(4): 539-546.
2.	Dorr MC, Backes M, Luitse JS, et al. Complications of Kirschner wire use in open reduction and internal fixation of calcaneal fractures. J Foot Ankle Surg, 2016, 55(5): 915-917.
3.	Kohl S, Meier S, Ahmad SS, et al. Accuracy of cartilage-specific 3-Tesla 3D-DESS magnetic resonance imaging in the diagnosis of chondral lesions: comparison with knee arthroscopy. J Orthop Surg Res, 2015, 10: 191.
4.	Schneider W, Jurenitsch S. Normative data for the American Orthopedic Foot and Ankle Society ankle-hindfoot, midfoot, hallux and lesser toes clinical rating system. Int Orthop, 2016, 40(2): 301-306.
5.	Hsu AR, Anderson RB, Cohen BE. Advances in surgical management of intra-articular calcaneus fractures. J Am Acad Orthop Surg, 2015, 23(7): 399-407.
6.	Basile A, Albo F, Via AG. Comparison between sinus tarsi approach and extensile lateral approach for treatment of closed displaced intra-articular calcaneal fractures: A multicenter prospective study. J Foot Ankle Surg, 2016, 55(3): 513-521.
7.	吴战坡, 陈伟, 张奇, 等. 距下关节创伤性关节炎原位植骨融合术后疗效与步态分析的临床研究. 中国修复重建外科杂志, 2011, 25(10): 1205-1209.
8.	米琨, 刘鹏飞, 刘武, 等. 关节镜下距下关节融合术治疗跟骨骨折畸形愈合. 中国修复重建外科杂志, 2010, 24(7): 875-877.
9.	Gorman TM, Beals TC, Nickisch F, et al. Hindfoot arthrodesis with the blade plate: Increased risk of complications and nonunion in a complex patient population. Clin Orthop Relat Res, 2016, 474(10): 2280-2299.
10.	Herrera-Pérez M, Andarcia-Bañuelos C, Barg A, et al. Comparison of cannulated screws versus compression staples for subtalar arthrodesis fixation. Foot Ankle Int, 2015, 36(2): 203-210.
11.	桂鉴超, 王黎明, 张理, 等. 关节镜下手术松解治疗跟骨骨折后距下关节僵硬. 中华外科杂志, 2009, 47(10): 774-777.
12.	Lee KB, Chung JY, Song EK, et al. Arthroscopic release for painful subtalar stiffness after intra-articular fractures of the calcaneum. J Bone Joint Surg (Br), 2008, 90(11): 1457-1461.
13.	Parisien JS, Vangsness T. Arthroscopy of the subtalar joint: an experimental approach. Arthroscopy, 1985, 1(1): 53-57.
14.	Frey C, Gasser S, Feder K. Arthroscopy of the subtalar joint. Foot Ankle Int, 1994, 15(8): 424-428.
15.	Giannoulis D, Papadopoulos DV, Lykissas MG, et al. Subtalar dislocation without associated fractures: Case report and review of literature. World J Orthop, 2015, 6(3): 374-379.
16.	Jung HG, Park JT, Shin MH, et al. Outcome of subtalar instability reconstruction using the semitendinosus allograft tendon and biotenodesis screws. Knee Surg Sports Traumatol Arthrosc, 2015, 23(8): 2376-2383.
17.	Lui TH, Chan KB. Arthroscopic management of late complications of calcaneal fractures. Knee Surg Sports Traumatol Arthrosc, 2013, 21(6): 1293-1299.
18.	Lui TH. Medial subtalar arthroscopy. Foot Ankle Int, 2012, 33(11): 1018-1023.

1. Stapleton JJ, Zgonis T. Surgical treatment of intra-articular calcaneal fractures. Clin Podiatr Med Surg, 2014, 31(4): 539-546.
2. Dorr MC, Backes M, Luitse JS, et al. Complications of Kirschner wire use in open reduction and internal fixation of calcaneal fractures. J Foot Ankle Surg, 2016, 55(5): 915-917.
3. Kohl S, Meier S, Ahmad SS, et al. Accuracy of cartilage-specific 3-Tesla 3D-DESS magnetic resonance imaging in the diagnosis of chondral lesions: comparison with knee arthroscopy. J Orthop Surg Res, 2015, 10: 191.
4. Schneider W, Jurenitsch S. Normative data for the American Orthopedic Foot and Ankle Society ankle-hindfoot, midfoot, hallux and lesser toes clinical rating system. Int Orthop, 2016, 40(2): 301-306.
5. Hsu AR, Anderson RB, Cohen BE. Advances in surgical management of intra-articular calcaneus fractures. J Am Acad Orthop Surg, 2015, 23(7): 399-407.
6. Basile A, Albo F, Via AG. Comparison between sinus tarsi approach and extensile lateral approach for treatment of closed displaced intra-articular calcaneal fractures: A multicenter prospective study. J Foot Ankle Surg, 2016, 55(3): 513-521.
7. 吴战坡, 陈伟, 张奇, 等. 距下关节创伤性关节炎原位植骨融合术后疗效与步态分析的临床研究. 中国修复重建外科杂志, 2011, 25(10): 1205-1209.
8. 米琨, 刘鹏飞, 刘武, 等. 关节镜下距下关节融合术治疗跟骨骨折畸形愈合. 中国修复重建外科杂志, 2010, 24(7): 875-877.
9. Gorman TM, Beals TC, Nickisch F, et al. Hindfoot arthrodesis with the blade plate: Increased risk of complications and nonunion in a complex patient population. Clin Orthop Relat Res, 2016, 474(10): 2280-2299.
10. Herrera-Pérez M, Andarcia-Bañuelos C, Barg A, et al. Comparison of cannulated screws versus compression staples for subtalar arthrodesis fixation. Foot Ankle Int, 2015, 36(2): 203-210.
11. 桂鉴超, 王黎明, 张理, 等. 关节镜下手术松解治疗跟骨骨折后距下关节僵硬. 中华外科杂志, 2009, 47(10): 774-777.
12. Lee KB, Chung JY, Song EK, et al. Arthroscopic release for painful subtalar stiffness after intra-articular fractures of the calcaneum. J Bone Joint Surg (Br), 2008, 90(11): 1457-1461.
13. Parisien JS, Vangsness T. Arthroscopy of the subtalar joint: an experimental approach. Arthroscopy, 1985, 1(1): 53-57.
14. Frey C, Gasser S, Feder K. Arthroscopy of the subtalar joint. Foot Ankle Int, 1994, 15(8): 424-428.
15. Giannoulis D, Papadopoulos DV, Lykissas MG, et al. Subtalar dislocation without associated fractures: Case report and review of literature. World J Orthop, 2015, 6(3): 374-379.
16. Jung HG, Park JT, Shin MH, et al. Outcome of subtalar instability reconstruction using the semitendinosus allograft tendon and biotenodesis screws. Knee Surg Sports Traumatol Arthrosc, 2015, 23(8): 2376-2383.
17. Lui TH, Chan KB. Arthroscopic management of late complications of calcaneal fractures. Knee Surg Sports Traumatol Arthrosc, 2013, 21(6): 1293-1299.
18. Lui TH. Medial subtalar arthroscopy. Foot Ankle Int, 2012, 33(11): 1018-1023.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of arthroscopic debridement and release for post-traumatic arthritis of subtalar joint

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