From the Guidelines
Secondary subtalar osteoarthritis is primarily caused by trauma, inflammatory arthropathies, congenital deformities, infection, avascular necrosis, neurological conditions, and iatrogenic causes, which all contribute to abnormal wear patterns and joint destruction. When considering the causes of secondary subtalar osteoarthritis, it is essential to evaluate the potential risk factors that may lead to the development of this condition.
- Trauma, particularly calcaneal fractures, is a significant cause of secondary subtalar osteoarthritis, as it disrupts the normal joint architecture and leads to abnormal wear patterns 1.
- Inflammatory arthropathies like rheumatoid arthritis and gout can trigger synovial inflammation and cartilage destruction, increasing the risk of developing secondary subtalar osteoarthritis.
- Congenital deformities such as tarsal coalition and flatfoot can alter biomechanics and increase joint stress, contributing to the development of secondary subtalar osteoarthritis.
- Infection, particularly septic arthritis, can directly damage cartilage and subchondral bone, leading to joint destruction and secondary subtalar osteoarthritis.
- Avascular necrosis of the talus following trauma or steroid use may lead to joint collapse and subsequent arthritis.
- Neurological conditions causing muscle imbalance or altered gait patterns contribute by creating abnormal joint loading, increasing the risk of secondary subtalar osteoarthritis.
- Iatrogenic causes, such as surgical complications or hardware impingement following foot surgeries, can also lead to secondary subtalar osteoarthritis.
- Systemic conditions like hemochromatosis and hemophilia can affect the subtalar joint through iron deposition or recurrent hemarthrosis, increasing the risk of developing secondary subtalar osteoarthritis. It is crucial to prioritize the patient's morbidity, mortality, and quality of life when evaluating and managing secondary subtalar osteoarthritis, and early diagnosis through clinical examination and imaging is essential to guide treatment approaches.
From the Research
Causes of Secondary Subtalar Osteoarthritis
- Secondary subtalar osteoarthritis can occur due to various factors, including:
- Traumatic arthritis secondary to a calcaneal fracture 2
- Partial or total arthrodesis of the subtalar and midtarsal joints 3
- Total ankle replacement (TAR) 4
- Septic arthritis, particularly in patients with primary immunodeficiency disorders 5
- Post-traumatic arthrosis, which can lead to fusion of the subtalar joint 6
- Risk factors for non-unions after arthrodesis of the subtalar joint include:
- Revision surgery
- Infection history in the area of operation
- Obesity
- Diabetes
- Cigarette smoking
- Alcohol abuse 6
- The presence of osteoarthritis in the subtalar joint can lead to pain and decreased functional outcomes, and may require further surgical intervention, such as fusion of the subtalar joint 3, 4, 6