Togher C, Vacketta V, Thompson J, Prissel M
Orthopedic Foot & Ankle Center, Worthington, United States
Calcaneal osteotomies have been described thoroughly in reduction of hindfoot and global deformities of the foot and ankle. Despite the high volume of studies involving calcaneal osteotomies in the correction of hindfoot deformities, few have investigated their protective value in the prevention of end-stage osteoarthritis of the subtalar joint. 255 consecutive patients who underwent various calcaneal osteotomies were reviewed. A minimum of 3 years of follow up was required for the present study. Patient charts were reviewed to evaluate rates of subtalar joint fusion secondary to deformity-driven osteoarthritis, hardware removal, and nonunion rates. Lateral radiographs were evaluated for preoperative and postoperative arthritis based on Kellgren Lawrence classification. After inclusion/exclusion criteria was applied, 44 patients with 55 calcaneal osteotomies were identified. 2.3% of patients underwent ipsilateral subtalar joint arthrodesis for treatment of deformity-driven osteoarthritis (1/44). Hardware removal and nonunion rates were 21.8% (12/55) and 2.3% (1/44), respectively. Despite a low incidence of subsequent subtalar joint arthrodesis to treat deformity-driven arthritis, Kellgren Lawrence grading proved an unreliable evaluation method for subtalar joint arthritis (Preoperative ICC = 0.664, Postoperative ICC = 0.459).
