Name of the Procedure:

Arthrodesis; triple
Common Names: Triple Arthrodesis, Triple Joint Fusion

Summary

Triple Arthrodesis is a surgical procedure that fuses three joints in the foot: the talonavicular, subtalar, and calcaneocuboid joints. This procedure aims to alleviate pain and provide stability by permanently joining these joints, eliminating movement that may cause discomfort.

Purpose

Medical Conditions:

• Severe arthritis
• Deformities in the foot
• Chronic instability
• Post-traumatic joint issues

Goals:

• Alleviate pain
• Correct deformities
• Improve foot stability
• Enhance overall foot function

Indications

Symptoms:

• Persistent foot pain
• Difficulty in walking or standing
• Foot deformity
• Swelling and stiffness in the foot

Patient Criteria:

• Patients with severe arthritis unresponsive to medication
• Deformities that impair mobility
• Chronic pain not alleviated by other treatments
• Individuals with previous unsuccessful foot surgeries

Preparation

Pre-procedure Instructions:

• Fasting for at least 8 hours before the procedure
• Adjustment or temporary discontinuation of certain medications
• Arrangements for post-surgery transportation

Diagnostic Tests:

• X-rays or MRI of the foot
• Blood tests
• Pre-surgery physical examination

Procedure Description

Steps:

1. Administration of general anesthesia.
2. Incisions made over the targeted joints.
3. Removal of cartilage from the joint surfaces.
4. Alignment of bones to the desired position.
5. Fixation of bones using screws, plates, or other hardware.
6. Closure of incisions with sutures.

Tools and Equipment:

• Surgical screws and plates
• Bone graft materials
• Standard surgical instruments

Anesthesia:

• General anesthesia to ensure the patient is asleep and pain-free during the procedure.

Duration

Typically 2 to 3 hours.

Setting

Performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic Surgeon
• Surgical Nurses
• Anesthesiologist

Risks and Complications

Common Risks:

• Infection
• Blood clots
• Bleeding
• Nerve damage

Rare Complications:

• Nonunion (failure of bone to fuse)
• Hardware irritation or failure
• Chronic pain at the surgery site

Benefits

Expected Benefits:

• Relief from chronic foot pain
• Improved foot stability
• Correction of deformities
• Enhanced ability to walk and stand properly

Realization Timeline:

Benefits typically start to be noticed a few weeks post-surgery, with full benefits realized after complete recovery.

Recovery

Post-procedure Care:

• Use of a cast or boot to immobilize the foot
• Crutches or a walker to prevent weight-bearing
• Pain management with prescribed medications
• Physical therapy to regain strength and mobility

Recovery Time:

• Initial recovery period: 6 to 8 weeks
• Total recovery time: Up to 6 months for complete healing

Restrictions:

• Avoiding weight-bearing on the treated foot
• Limited physical activities following guidelines from the surgeon

Follow-up:

• Regular follow-up appointments for X-rays and progress assessments

Alternatives

Other Treatment Options:

• Conservative measures (physical therapy, orthotic devices)
• Medications (anti-inflammatory drugs)
• Other surgical options like partial joint fusion or joint replacement

Pros and Cons:

• Alternatives may avoid surgery but might not offer long-term relief.
• Triple Arthrodesis provides more definitive and lasting resolution, especially for severe cases.

Patient Experience

During the Procedure:

• The patient is under general anesthesia and will not feel anything.

After the Procedure:

• Initial pain and swelling managed by medications.
• Immobilization and restricted activity for several weeks.
• Gradual return to normal activities with guided rehabilitation.