J Korean Orthop Assoc.  2018 Apr;53(2):93-102. 10.4055/jkoa.2018.53.2.93.

Subtalar Arthroscopy and Posterior Endoscopy

• Yoo TW
• Ahn JH
• Kim J

• KMID: 2410056
• DOI: http://doi.org/10.4055/jkoa.2018.53.2.93

Abstract

The application of arthroscopy is becoming increasingly widespread due to the development of surgical instruments and techniques. Subtalar pathology can cause chronic pain in the hindfoot, but it is often misdiagnosed as a lesion of the adjacent ankle joint, which can lead to delayed diagnosis and treatment. Subtalar arthroscopy and posterior endoscopy are good methods to confirm and treat the posterior pathology of the subtalar joint and posterior ankle joint.

Keyword

subtalar joint; subtalar arthroscopy; posterior endoscopy

MeSH Terms

Ankle Joint
Arthroscopy*
Chronic Pain
Delayed Diagnosis
Endoscopy*
Pathology
Subtalar Joint
Surgical Instruments

Figure

• 

  Figure 1 Photograph showing the three portals used in subtalar arthroscopy. Normal saline is injected into the subtalar joint through the posterolateral portal.

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  Figure 2 Arthroscopic findings showing the inside view of the subtalar joint. (A) Zone 1, which is the anteromedial side of posterior calcaneal facet, is viewed through the middle portal. (B) Zone 4, which is the anterolateral side of subtalar joint, is viewed through the anterolateral portal. T, talus; C, calcaneus; I, interosseous talocalcaneal ligament.

• 

  Figure 3 (A) Standing lateral radiograph of the right foot of a 27-year-old male patient showing painful Os trigonum (Os) (arrow). (B) This arthroscopic finding demonstrates large Os. C, calcaneus. (C) The Os is mobilized with an arthroscopic curette. (D) The Os is removed completely. (E) Standing lateral radiograph at postoperative 1 year shows the cleared posterior ankle space with removal of Os.

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  Figure 4 Photograph shows the posterior two-portal posterior endoscopic procedure.

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  Figure 5 (A) Standing lateral radiograph of the left foot of a 52-year-old male rheumatoid arthritis patient showing severe narrowing of the subtalar joint space. (B) Posterior endoscopic finding shows the preparation of joint surface with a burr. T, talus; C, calcaneus. (C) Morsellized bone grafts are inserted through the arthroscopic sheath. (D) Lateral radiograph taken 2 weeks postoperatively shows that the subtalar joint is well fixated with 3 screws. (E) Radiograph taken 14 months postoperatively demonstrates satisfactorily fused subtalat joint.

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