Outcomes Following Revision Subtalar Arthrodesis: A Retrospective Review

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Prior studies conducted on subtalar arthrodesis have reported high patient satisfaction, low complication rates, and low rates of revision. To our knowledge, no study has assessed outcomes following revision subtalar fusion. We aim to expand the knowledge on this procedure through an analysis of fusion rates among patients having undergone revision subtalar fusion. Methods: The electronic medical record was searched using the current procedural terminology (CPT) codes 27870 and 28725. Patients were collected at a single institution between 2011 and 2024. Inclusion criteria included being 18 years of age or older and a history of revision subtalar fusion. Patients were excluded for loss to follow-up, insufficient postoperative imaging, and no history of revision surgery. After exclusion criteria, 67 patients were identified. Demographics, reason for revision, and comorbidities were collected through chart review. A radiographic analysis was performed using the hospital’s picture archiving and communication system. Descriptive statistics were utilized to assess patient demographics, reasons for revision and the frequency of fusion. Chi-squared analyses were conducted to assess the relationship between the reasons for revision and achievement of fusion with significance determined as p < 0.05. Results: 43.3% of patients were male and 56.7% were female. 61.9% of patients were obese, 9.0% had a history of diabetes, 3.0% had a history of rheumatoid arthritis, 19.4% had a history of osteoarthritis, and 14.9% had a history of chronic pain. Nonunion was the most common reason for revision at 82.09%, followed by arthrosis at 10.45%, and symptomatic hardware at 9.0%. 63 of the 67 patients (94.0%) achieved fusion of the subtalar joint. Chi-squared analysis yielded no significant relationship between reason for revision and achievement of fusion. Conclusion: Fusion rates following revision subtalar arthrodesis are similar to those of primary fusion. This finding suggests that revision subtalar arthrodesis can be as effective as primary arthrodesis, potentially guiding treatment decisions and patient expectations.