29907 Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis

Name of the Procedure:

Arthroscopy, Subtalar Joint, Surgical; with Subtalar Arthrodesis (fusion)

Summary

Arthroscopy of the subtalar joint with subtalar arthrodesis is a minimally invasive surgical procedure used to diagnose and treat conditions of the subtalar joint, located in the foot. The procedure involves the fusion of the joint to alleviate pain or restore stability.

Purpose

This procedure addresses conditions such as severe arthritis, chronic instability, or traumatic injuries of the subtalar joint. The goal is to relieve pain, improve foot function and alignment, and enhance the overall quality of life.

Indications

• Severe pain due to arthritis or degenerative joint disease
• Chronic instability or deformity
• Traumatic injuries and non-union fractures
• Failed conservative treatments (physical therapy, medications)

Preparation

• Fasting for 6-12 hours before the procedure
• Adjusting or discontinuing certain medications as advised by the doctor
• Preoperative imaging studies (e.g., X-rays, CT scans, MRIs)
• Blood tests and a general health evaluation

Procedure Description

1. The patient receives general anesthesia or regional nerve block.
2. Small incisions are made around the subtalar joint.
3. An arthroscope (a small camera) and surgical instruments are inserted through the incisions.
4. The surgeon examines and treats any damage within the joint.
5. The joint surfaces are prepared, and bone graft material is inserted to promote fusion.
6. The joint is immobilized using screws or other fixation devices.
7. The incisions are closed with sutures or surgical staples.

Duration

The procedure typically takes 1-2 hours, depending on the complexity.

Setting

This procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Operating room technicians

Risks and Complications

• Infection
• Blood clots
• Nerve damage
• Non-union or delayed healing
• Complications from anesthesia
• Pain and swelling

Benefits

• Significant pain relief
• Improved foot function and stability
• Enhanced mobility and quality of life
• Fusion of the joint may take several months to complete fully, but initial pain relief is often noticed soon after recovery.

Recovery

• Post-procedure pain management with medications
• Immobilization with a cast or boot for several weeks
• Physical therapy to restore strength and mobility
• Follow-up appointments to monitor healing
• Full recovery may take 3-6 months, with some restrictions on weight-bearing activities.

Alternatives

• Non-surgical treatments (pain management, orthotics, physical therapy)
• Other surgical procedures (osteotomy, subtalar joint debridement)
• Pros: Less invasive options may require less recovery time.
• Cons: Non-surgical treatments may not provide long-term relief.

Patient Experience

The patient may experience mild to moderate pain and swelling after the procedure. Pain management includes medications and possibly cold therapy. The use of crutches or a walker may be necessary during the initial recovery period. Regular follow-ups are essential to ensure proper healing and recovery.