Triple arthrodesis of the hindfoot: a long-term prospective outcome study

Triple arthrodesis is an operative salvage procedure for treatment of painful,
deformed and/or unstable tarsal joints. However, debate exists regarding the
effect of triple fusion on the development of osteoarthritis (OA) of the ankle
joint. Since, triple arthrodesis is a technical difficult procedure and
correction of the shape/alignment of the foot may be not as adequate as
intended, malalignment might persist after operative correction. Malalignment
may be more important in determining OA of the ankle than the fusion itself.
The hypothesis is that after a mean follow up time of 15 years, the geometry
and subjective outcome would remain improved. Compared with the earlier
evaluation (at 2 and 7.5 years), an increase of OA of the ankle joint is
expected. More specific, the increase of OA is expected to be mild and
associated with pre-existing OA of the ankle joint and/or associated with
persistent malalignment of the foot after triple fusion.

The objective of the present study is to investigate the long-term effect (15
years follow-up) of triple arthrodesis on the ankle joint and the development
of secondary OA of the ankle joint. Additionally, alignment and clinical
outcomes will be examined.

This follow-up study is a prospective cohort study

Patients are asked to visit our clinic once. The extra amount of time that a
patient invests in the study is about 1 hour. Prior to the visit the patients
are asked to fill in a questionnaire (FFI), during the visit X-rays and digital
photos of the ankle/foot will be taken and the physician will perform a
physical examination (AOFAS). The questionnaires and physical examination of
the foot do not bring any extra burden. The additional radiological assessment
has a radiation amount of 0.001 mSv and is minimal compared with the natural
radiation of 2 mSv per year.