Evaluation of complications in hindfoot arthrodesis

Abstract

Objective: The hindfoot arthrodesis is used to relieve pain and correct deformities caused by various diseases, in cases refractory to conservative treatment. Despite the limitation of mobility, there is improvement in limb function. The aim of this study was to evaluate the complications of isolated and combined arthrodeses of the hindfoot, analyzing the appearance of degenerative changes in adjacent joints and other complications. Methods: We evaluated retrospectively 33 adult patients undergoing different types of hindfoot arthrodesis between January 2005 and January 2012. The clinical evaluation criterion was the American Orthopaedic Foot Ankle Society Hindfoot- Ankle score, in its Portuguese version. Furthermore, we applied a standard questionnaire about the evolution of each patient. The radiological follow-up included radiographs to confirm the bone consolidation and development of osteoarthritis. Results: The posterior tibial tendon dysfunction was the most common underlying disease observed, affecting 11 patients. The classification based on the American Orthopaedic Foot Ankle Society score showed, postoperatively, 21 excellent results (61%), 9 good (26.5%), 4 regular (11.7%) and no bad. Fifteen cases had any complications, among them two pseudoarthrosis. In 26.5% of cases, there was progression to osteoarthritis in joints surrounding. Conclusion: The hindfoot arthrodesis showed good results in relieving pain and correct deformities. Proper alignment of the rearfoot seems to be the most important parameter for obtaining good results. The development of osteoarthritis in joints adjacent to arthrodesis is relatively frequent, however seems to be asymptomatic.