The subtalar joint, is below the ankle, between the talus and calcaneus bone, is the first foot joint. Along with the knee, the subtalar joint, plays a key role in cushioning body weight, with braces or impacts, walking, running or jumping.
The most common cause is a traumatic injury, either by repetition microtrauma or by a fracture of the calcaneus or body or tail of the talus. The back of the joint (posterior subtalar) is the most frequently affected.
Other causes include autoimmune diseases such as rheumatoid arthritis, infections, sequelae of calcaneal fractures, congenital deformities uncorrected position of the talus or calcaneus or posterior tibial tendon dysfunction.
Patients with symptomatic osteoarthritis complain hindfoot often pain, swelling and stiffness of the back foot and on the side and back of the ankle, worse when walking on uneven ground, running or doing sport. The pain usually improves with rest or with the use of special shoes.
The orthopedic surgeons must analyze the gait disturbance, the position of the feet, and the general alignment, identifying the varus or valgus, if there are deformities and whether they are flexible or not, if corrected with the various positions. Clinical examination objective swelling or stiffness of the subtalar joint to move the hindfoot side by side, in eversion and supination.
Radiography is essential for a proper assessment of alignment and degree of osteoarthritis of the subtalar joint and the neighboring joints.
Arthrosis ankle and subtalar back
Conservative treatment of subtalar arthrosis
The goal of treatment is to limit the painful joint movement, to accommodate the tread, correct the misalignment and relieve download and pressure points.
Conservative treatment of subtalar arthrosis is based on recommendations to slow the progression of the disease.
Some of them are:
- Do not walk, run or jump too on uneven ground.
- Perform physical therapy and exercise without impact: pool, bicycle (help mobility, proprioception and strength)
- Modify physical activity avoiding activities that cause pain.
- If Overweight follow a diet to lose weight, along with the exercises described.
- Pain medication or anti-inflammatory drugs.
- Footwear modification, use of braces or custom correction to stabilize the tarsal joint and middle joint.
- In the early stages, can help the protective cartilage, intra-articular injections of hyaluronic acid, platelet rich plasma or conditioned autologous serum (Orthokine®).
Surgical treatment of subtalar arthrosis
It uses the surgical treatment when the patient 's pain is disabling and prevents you from doing a normal life.
The operation consists of a merger or joint arthrodesis. It is indicated in cases of osteoarthritis or arthritis pain, instability or deformity of the joint, which has not improved with conservative treatment.
Loss of mobility for the patient is minimal because the disease is already limiting movement. Usually the patient retains a residual mobility, but painful, so all the rest annular mobility can eliminate pain and improve the function of the rest of the ankle and foot.