Subtalar Joint Arthritis

• Pain especially with activity
• Pain first thing in the morning
• Progressive stiffness
• Difficulty walking on uneven ground
• Swelling, clicking and catching

• Primary osteoarthritis with articular cartilage damage
• Secondary osteoarthritis:
  • related to trauma or previous fracture
  • increased joint stress from adjacent joint disease
• Inflammatory arthropathy
  • most commonly rheumatoid arthritis

• Weight-bearing X-rays are required with additional views
• Long leg X-rays, CT scans or MRI scans may be required

• Topical pain creams e.g. NSAIDS
• Pain medications e.g. NSAIDS such as Mobic or Panadol Osteo
• Lace up ankle brace, ankle foot orthosis aka AFO brace
• University of California-Berkeley Lab orthosis aka UCBL orthosis
• Shoe wear modification
  • lace up ankle boots
  • stiffer soled shoe with rocker bottom modification
• Activity modification:
  • improve fitness and strength via non axial loading exercises e.g. cycling, swimming
  • avoid axial loading exercises e.g. running
• Weight loss management
• Joint injections

• Arthroscopic procedures

• Arthroscopic fusion

• Open fusion

All surgery has risks involved, however every effort is made to reduce these risks. Risks include but are not limited to:

• Infection: superficial wounds or deep infections
• Clots: DVT (deep venous thrombosis) or PE (pulmonary embolus)
• Nerve damage: tingling, numbness or burning
• Ongoing pain
• Stiffness of the ankle joint
• General or anaesthetic risks including to the heart and lung
• Drug reactions/allergy
• Scarring or tethering of the skin
• Rupture
• Calf weakness
• Revision surgery

There are increased risks of surgery in diabetics, smokers, significant peripheral vascular disease, severe neuropathy, previous or current infection which may preclude a patient from surgery.

View FootForward for Diabetes (run by Diabetes Australia) for more information on foot care.