From the Research
Arthrodesis is a viable treatment option for tarsal coalition, as it provides pain relief and stability by eliminating motion at the affected joint, despite its potential to further limit range of motion at the midfoot. The decision to perform arthrodesis is typically reserved for patients who have failed conservative management and coalition resection, particularly when there is significant degenerative arthritis at the coalition site or when the coalition involves more than 50% of the joint surface 1. This procedure is often considered a salvage procedure, aimed at alleviating pain and improving quality of life for patients with severe symptoms.
The goal of arthrodesis in tarsal coalition is to trade some degree of motion, which is already compromised, for pain relief and stability. The specific joints fused depend on which coalition is present, typically the calcaneocuboid, talonavicular, or subtalar joints. Post-surgery, patients require 6-12 weeks of immobilization followed by physical therapy to adapt to the new biomechanics of their foot. According to the most recent study 1, arthrodesis is indicated as a salvage procedure whenever treatment fails or with advanced arthrosis.
Some key points to consider when evaluating the use of arthrodesis in tarsal coalition include:
- The type and extent of the coalition, as characterized by preoperative radiographs and CT scans 2
- The presence of significant degenerative arthritis at the coalition site 3
- The involvement of more than 50% of the joint surface 1
- The failure of conservative management and coalition resection 4
- The potential benefits of arthrodesis in alleviating pain and improving quality of life for patients with severe symptoms.
Overall, while arthrodesis may seem counterintuitive in the treatment of tarsal coalition, it can be a effective option for patients who have failed other treatments and are experiencing significant pain and disability. As noted in the most recent study 1, the goal of treatment is to alleviate patient symptomatology and provide excellent long-term benefits, and arthrodesis can be a valuable tool in achieving this goal.