Skip to main content

Advertisement

Log in

Long-term results after a triple arthrodesis of the hindfoot: function and satisfaction in 36 patients

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

The long-term functional results of a triple arthrodesis of the hindfoot are not well known. In this retrospective cohort study we therefore investigated pain, function and aligment of the tibiotalar joint, patient satisfaction with the procedure and the prevalence of osteoarthritis (OA) of the tibiotalar joint after a median follow-up of six years. We also aimed to investigate whether there are patient and surgical characteristics associated with the outcome. Patients who underwent a triple arthrodesis for OA between January 1992 and July 2002 were invited to participate. A clinical examination was performed, the Ankle-Hindfoot Scale was completed, and radiographs were taken. Patient characteristics (e.g., age, gender and the indication for operation) and surgical characteristics (e.g., fixation material and use of bone graft) were collected. Sixty-one percent (22 patients) of the patients had a good total score on the Ankle-Hindfoot Scale. Nineteen patients (53%) were satisfied with the result of the operation and 47% of the patients had radiographic OA of the tibiotalar joint. In a univariate regression analysis, male gender and the score on the Ankle-Hindfoot Scale were significantly associated with radiographic OA. Patient satisfaction was significantly associated with a higher score on the Ankle-Hindfoot Scale and better dorsi–flexion of the ankle. Our study shows that 61% of the procedures in 36 patients with a triple arthrodesis for OA had a good score on the Ankle-Hindfoot Scale. Radiographic OA of the ankle was present in 47% of the cases and was not related to patient satisfaction. No patient characteristics or surgical characteristics were associated with the score on the Ankle-Hindfoot Scale.

Résumé

Les résultats fonctionnels à long terme de la triple arthrodèse de l’arrière pied sont maintenant bien connus. Nous avons réalisé une analyse rétrospective d’une cohorte de patients avec étude de la douleur, du fonctionnement et de la position de l’articulation tibiotalienne ainsi que de la satisfaction des patients. Nous avons également évalué la prévalence de l’arthrose (OA) de l’articulation tibiotalienne sur un suivi moyen de 6 ans. Méthode: les patients ayant bénéficié d’une triple arthrodèse ont été analysés. Ces patients ont été opérés entre Janvier 1992 et Juillet 2002. Un examen clinique a été réalisé ainsi que des radiographies. Ont été également analysés, l’âge, l’état général des patients, le sexe, l’indication ainsi que la technique opératoire : matériel de fixation, utilisation de greffes. 61% (22 patients) des patients avaient de bons résultats selon le score Ankle-Hindfoot Scale. Dix-neuf patients (53%) ont été satisfaits du résultat et 47% des patients avaient une radiographie avec une arthrose de l’articulation tibiotalienne. Lors de l’analyse, nous avons mis en évidence pour le sexe masculin que le score Ankle-Hindfoot Scale était de façon significative associé à des signes d’arthrose radiologique, la satisfaction des patients était significativement associée au score élevé de Ankle-Hindfoot Scale et une meilleure flexion de la cheville. Notre étude montre que 61% des procédures chirurgicales sur 36 patients ayant bénéficié d’une triple arthrodèse ont un bon score selon l’échelle Ankle-Indfoot. Une arthrose de la cheville était présente dans 47% des cas mais sans aucune relation avec la satisfaction des patients. Aucune caractéristique des patients ou du traitement chirurgical n’était associé au score Ankle-Hindfoot Scale.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Angus PD, Cowell HR (1986) Triple arthrodesis. A critical long-term review. J Bone Joint Surg Br 68:260–265

    PubMed  CAS  Google Scholar 

  2. Bednarz PA, Monroe MT, Manoli A 2nd (1999) Triple arthrodesis in adults using rigid internal fixation: an assessment of outcome. Foot Ankle Int 20:356–363

    PubMed  CAS  Google Scholar 

  3. Beischer AD, Brodsky JW, Pollo FE, Peereboom J (1999) Functional outcome and gait analysis after triple or double arthrodesis. Foot Ankle Int 20:545–553

    PubMed  CAS  Google Scholar 

  4. Cobb TK, Gabrielsen TA, Campbell DC 2nd, Wallrichs SL, Ilstrup DM (1994) Cigarette smoking and nonunion after ankle arthrodesis. Foot Ankle Int 15:64–67

    PubMed  CAS  Google Scholar 

  5. de Heus JA, Marti RK, Besselaar PP, Albers GH (1997) The influence of subtalar and triple arthrodesis on the tibiotalar joint. A long-term follow-up study. J Bone Joint Surg Br 79:644–647

    Article  PubMed  Google Scholar 

  6. Donatto KC (1998) Arthritis and arthrodesis of the hindfoot. Clin Orthop 81–92

  7. Ishikawa SN, Murphy GA, Richardson EG (2002) The effect of cigarette smoking on hindfoot fusions. Foot Ankle Int 23:996– 998

    PubMed  Google Scholar 

  8. Kann JN, Parks BG, Schon LC (1999) Biomechanical evaluation of two different screw positions for fusion of the calcaneocuboid joint. Foot Ankle Int 20:33–36

    PubMed  CAS  Google Scholar 

  9. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349–353

    PubMed  CAS  Google Scholar 

  10. Meyer MS, Alvarez BE, Njus GO, Bennett GL (1996) Triple arthrodesis: a biomechanical evaluation of screw versus staple fixation. Foot Ankle Int 17:764–767

    PubMed  CAS  Google Scholar 

  11. Pell RF 4th, Myerson MS, Schon LC (2000) Clinical outcome after primary triple arthrodesis. J Bone Joint Surg Am 82:47–57

    PubMed  Google Scholar 

  12. Saltzman CL, Fehrle MJ, Cooper RR, Spencer EC, Ponseti IV (1999) Triple arthrodesis: twenty-five and forty-four-year average follow-up of the same patients. J Bone Joint Surg Am 81:1391–1402

    PubMed  CAS  Google Scholar 

  13. Southwell RB, Sherman FC (1981) Triple arthrodesis: a long-term study with force plate analysis. Foot Ankle 2:15–24

    PubMed  CAS  Google Scholar 

  14. van Dijk CN, Lim LS, Poortman A, Strubbe EH, Marti RK (1995) Degenerative joint disease in female ballet dancers. Am J Sports Med 23:295–300

    Article  PubMed  Google Scholar 

  15. Wetmore RS, Drennan JC (1989) Long-term results of triple arthrodesis in Charcot-Marie-Tooth disease. J Bone Joint Surg Am 71:417–422

    PubMed  CAS  Google Scholar 

  16. Wulker N, Flamme C (1996) Hindfoot arthrodesis. Orthopade 25:177–186

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ingrid B. de Groot.

Appendix

Appendix

Table 4 The grading of radiological evidence of osteoarthritis of the ankle according to Van Dijk et al. [11]

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Groot, I.B., Reijman, M., Luning, H.A.F. et al. Long-term results after a triple arthrodesis of the hindfoot: function and satisfaction in 36 patients. International Orthopaedics (SICO 32, 237–241 (2008). https://doi.org/10.1007/s00264-006-0295-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-006-0295-4

Keywords

Navigation