• Title/Summary/Keyword: Subtalar arthroscopy

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Subtalar Arthroscopy (거골하 관절의 관절경술)

  • Ahn, Jae-Hoon
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.235-241
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    • 2009
  • The development of good quality small-diametered arthroscopes and refined arthroscopic techniques has contributed to the improvement of the subtalar arthroscopy. The therapeutic indications are synovectomy, removal of loose bodies, debridement and drilling of osteochondritis dissecans, excision of subtalar impingement lesions and osteophytes, lysis of adhesions for post-traumatic arthrofibrosis, removal of a symptomatic os trigonum, calcaneal fracture assessment and reduction, and arthroscopic arthrodesis of the subtalar joint. The subtalar arthroscopy can be done in supine position using thigh holder or in lateral decubitus position. The arthroscope generally used is a 2.7-mm 30 degrees short arthroscope. Noninvasive distraction with a strap around the hindfoot can be helpful. Usually anterolateral, middle and posterolateral portals are utilized for inspection and instrumentation within the joint. Twoportal posterior subtalar arthroscopy in prone position can be performed as well with 4.0-mm 30 degrees arthroscope, depending on the type and location of the subtalar pathology. The subtalar arthroscopy is a technically demanding procedure, which requires proper instrumentation and careful operative technique. Possible complications are nerve damage and persistent wound drainage.

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Subtalar Arthroscopy (거골하 관절경술)

  • Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.26-30
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    • 2012
  • The subtalar joint is a complex joint that is functionally responsible for inversion and eversion of the hindfoot. Advances in optical technology and surgical instrumentation have allowed the arthorscocpic surgeon to investiagate the small joints including the subtalar joint. Indications for subtalar arthroscopy include pain, swelling, stiffness and locking. Therapeutic indications include treatment of chondromalacia, osteophytes, arthrofibrosis, synovitis, loose bodies, osteochondral lesions, excision of a painful os trigonum, arthrodesis, and FHL tendinopathy. Contraindications to subtalar arthroscopy include infection, advanced osteoarthritis with deformity, severe edema, poor vascularity and poor skin quality. Subtalar arthroscopy is a technically demanding and difficult procedure that should only be performed by experienced surgeons. With proper instrumentation and careful operative techniques, satisfactory results may be obtained with minimal morbidity.

Use of Subtalar Arthroscopy in Intra-Articular Calcaneus Fractures (관절 내 종골 골절에서 거골하 관절경술의 이용)

  • Inha Woo;Chul Hyun Park
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.1
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    • pp.1-6
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    • 2023
  • Displaced intra-articular calcaneal fractures are difficult to treat because of complex anatomy and high soft tissue complications. Various surgical approaches have been introduced to solve these problems, but the treatment remains complex. Recently, clinically and radiographically superior results were reported using a subtalar arthroscopy in reducing the posterior facet in both percutaneous and open approaches. In the percutaneous approach, the arthroscopically assistant percutaneous approach must be selected carefully for mild-to-moderately displaced fractures because of the limited view. In the open approach, there is little evidence of the utility of subtalar arthroscopy. Therefore, intraoperative arthroscopy should always be used in conjunction with fluoroscopy to achieve reduction and assess the internal fixation placement.

Subtalar Arthroscopy : Indication and Results (거골하 관절경 : 적응증과 그 결과)

  • Ahn, Jae-Hoon;Lee, Kwang-Won;Kim, Ha-Yong;Lee, Seung-Hun;Choy, Won-Sik;Kim, Seung-Kwon
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.39-44
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    • 2007
  • Purpose: To evaluate the results of subtalar arthroscopy and to define the indications for the procedure. Materials and Methods: Fifty-four patients were followed up for more than 1 year after subtalar arthroscopy. The mean age was 40 years, and the mean follow-up period was 18 months. Preoperative diagnoses included sinus tarsi syndrome in 19 cases, degenerative arthritis in 13 cases, calcaneal fracture in 10 cases, arthrofibrosis in 5 cases, os trigonum syndrome in 3 cases, talar fracture in 3 cases, talocalcaneal coalition in 3 cases and calcaneal tumor in 1 case. Clinically AOFAS ankle-hindfoot scale and satisfaction of the patients were evaluated. Results: There were 23 synovectomies, 13 subtalar fusions, 11 diagnostic arthroscopies, 5 adhesiolyses, 4 loose body removals, 3 excisions of os trigonum and 1 arthroscopic reduction of fracture. Twenty-five ankle arthroscopies and 11 modified Brostrom's operations were performed for the accompaning 17 ankle impingment syndromes, 11 chronic ankle instabilities and 7 osteochondral lesions of talus. AOFAS ankle-hindfoot scale was increased from 33 points preoperatively to 77 points postoperatively in subtalar fusion group, and was increased from 69 points preoperatively to 89 points postoperatively in other-than-fusion group. Ninety one percent of patients were satisfied with the procedures. There were no serious complications related to the subtalar arthroscopy. Conclusion: Subtalar arthroscopy appears to be safe and highly accurate procedure for subtalar pathology, although it requires technical expertise.

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Various Pathologic Conditions of Sinus Tarsi Syndrome Assessed by Imaging and Arthroscopic Findings (영상학적 및 관절경적 소견으로 평가한 족근동 증후군의 다양한 병적 상태)

  • Jeong Jin Park;Seung Jae Cho;Seong Hyeon Jo;Chul Hyun Park
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.2
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    • pp.60-67
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    • 2024
  • Purpose: Sinus tarsi syndrome (STS) is caused by various pathologies. However, the exact etiology of STS remains controversial. This study evaluated the imaging and arthroscopic findings of patients who underwent surgical treatment after conservative treatment for STS failed. Materials and Methods: Between December 2014 and August 2018, 20 patients (21 cases) who underwent surgical treatment for STS were included in the study. The clinical results were analyzed using the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot functional scale. The radiographic results were analyzed using Meary's angle, calcaneal pitch angle, and hindfoot alignment angle. The pathologic conditions of sinus tarsi were confirmed by magnetic resonance imaging (MRI) and subtalar arthroscopy. Synovitis, bone edema, and accessory anterolateral talar facet (AALTF) were evaluated on MRI. Synovial thickening, cartilage damage, interosseous talocalcaneal ligament (ITCL) and cervical ligament rupture, soft tissue impingement, AALTF, and accessory talar facet impingement (ATFI) were evaluated by subtalar arthroscopy. Results: The mean duration of symptoms was 28.7 months (4~120). All patients showed significant improvement in the VAS and AOFAS ankle-hindfoot scale. Significant improvements in hindfoot alignment angle and Meary's angle postoperatively were noted in patients who underwent medial displacement calcaneal osteotomy. MRI confirmed synovitis in all patients, AALTF in 19 cases (90.5%), and ATFI with bone edema in seven cases (33.3%). In subtalar arthroscopy, pathologic conditions were observed in the following order: synovitis in 21 cases (100%), AALTF in 20 cases (95.2%), ITCL partial rupture in nine cases (42.9%), and soft tissue impingement in seven cases (33.3%). All cases had two or more pathological conditions, and 15 (71.4%) had three or more. Conclusion: In cases of STS that do not respond to conservative treatment, a comprehensive examination of the lesions of the tarsal sinus and lesions around the subtalar joint is essential.