Subtalar Arthroscopy

Introduction

Subtalar arthroscopy is a surgical procedure performed to treat pain caused by problems of the subtalar joint in the ankle. The surgery is minimally invasive, performed through small incisions, by using an viewing instrument called an arthroscope. An arthroscope is a thin long tube with a camera attached, which helps your surgeon clearly view the surgical site on a monitor.

Disease Overview

The subtalar joint is a complex joint located below the ankle joint and is formed by the union of the heel (calcaneus) and the talus (ankle) bone. The subtalar joint allows side-side movement of the foot. This joint can be injured with a sprain or fracture of the talus or calcaneus bones, causing pain and instability.

Indications

Subtalar arthroscopy is indicated when non-surgical methods do not help the following conditions:

• scar tissue present in the subtalar region
• severe sprains
• twisting injuries
• fractures of the talus or calcaneus bones

It is also recommended for subtalar joint fusion.

Subtalar arthroscopy may be contraindicated in:

• patients with severe subtalar joint problems, who may require larger incisions
• poor leg circulation
• active infection
• diseases such as uncontrolled diabetes

Surgical procedure

Subtalar arthroscopy is performed under general anesthesia or a nerve block. Saline solution is injected into the ankle to expand the area for better viewing. Your surgeon makes 2 to 3 small incisions on your ankle. The arthroscope and other surgical incisions are inserted through these incisions. Images from the arthroscope can be viewed on a monitor by your surgeon to perform the procedure. Special tools such as biters, graspers and motorized shavers are used to repair the damage to the subtalar joint. Once the problem has been treated the surgical instruments are removed and the incisions are closed.

Post-Operative Care

After the surgery, your foot will be placed in either a plaster, splint or a removable boot to immobilize the joint, and reduce swelling and pain. You will be advised to use crutches so you do not bear weight on your foot. Physical therapy will be ordered to assist with strengthening exercises and range of motion. Recovery may take 6 to 12 months.

Advantages

The advantages of subtalar arthroscopy over traditional open surgery include:

• Less post-operation pain, disability and swelling
• Shorter hospital stay
• Faster recovery

Risks and complications

As with all surgical procedures, subtalar arthroscopy may be associated with certain complications such as:

• Risks related to anesthesia
• Infection
• Problems in wound healing
• Injury to neighboring nerves or blood vessels
• Bleeding
• Blood clots