Arthroscopic Triple Arthrodesis

Preparation

Every patient requires an individual orthopaedic assessment and detailed diagnostic evaluation before surgery.

The qualification process may include:

• specialist consultation,
• imaging diagnostics,
• assessment of deformity and instability,
• gait and biomechanical analysis,
• evaluation of degenerative joint changes,
• review of previous treatment and its effectiveness,
• assessment of activity level and functional expectations.

Arthroscopic triple arthrodesis may be considered in more complex cases, including:

• advanced degenerative changes in the hindfoot,
• foot deformities, including flatfoot deformity,
• chronic instability of the hindfoot joints,
• post-traumatic conditions affecting gait biomechanics,
• inflammatory diseases leading to joint destruction,
• progressive deformities impairing foot function,
• chronic pain limiting walking and daily activities,
• overload of adjacent foot structures caused by abnormal alignment,
• unsuccessful conservative treatment, including rehabilitation, pain management, orthotic support, or other therapeutic measures.

Surgical treatment is typically considered when foot pathology begins to affect not only walking comfort, but also mobility, safety, and overall quality of life.

Convalescence

Recovery after arthroscopic triple arthrodesis requires patience and strict adherence to postoperative recommendations.

During the initial phase, patients typically need to:

• avoid weight-bearing on the operated limb,
• use crutches for mobility,
• attend follow-up appointments to monitor bone fusion,
• gradually increase activity levels according to medical recommendations.

Rehabilitation is tailored individually and helps the foot adapt to its new biomechanics.

The healing process depends on the extent of the procedure, bone fusion progress, the patient’s general condition, and adherence to post-operative instructions.

Although joint fusion limits motion within the treated joints, other foot structures may partially compensate for the lost movement over time.

Precautions

Arthroscopic triple arthrodesis is generally performed when the primary goals of treatment are long-term pain relief, correction of foot alignment, and restoration of stability that could not be achieved through conservative treatment.

Progressive deformities and instability of the foot tend to worsen over time.

Without appropriate treatment, this may lead to:

• increasing pain,
• worsening foot alignment,
• overload of adjacent joints,
• reduced mobility and walking comfort,
• progression of degenerative changes.

Because the procedure permanently fuses several joints, careful patient selection and individual surgical planning are essential.

Each case is assessed based on imaging studies, severity of deformity, foot biomechanics, activity level, previous treatment history, and the patient’s functional goals.

Benefits

The primary objective of arthroscopic triple arthrodesis is to reduce or eliminate pain and improve overall foot function.

Potential benefits include:

• improved stability while walking,
• better foot alignment,
• reduced pain,
• reduced mechanical overload,
• greater comfort during daily activities,
• improved walking confidence,
• improved foot biomechanics,
• better quality of daily life.

The arthroscopic approach may also support:

• smaller incisions,
• reduced soft tissue damage,
• lower risk of complications,
• shorter hospital stay,
• faster recovery compared with traditional open procedures,
• highly precise assessment of joint structures.

For many patients, the greatest benefit is the elimination of chronic pain and improvement in stability during walking.

What is arthroscopic triple arthrodesis?

Arthroscopic triple arthrodesis is an advanced surgical procedure that permanently fuses three joints in the hindfoot.

The goal of treatment is to relieve pain, improve foot alignment, and restore stability when conservative treatment no longer provides satisfactory results.

Which joints are fused during triple arthrodesis?

Triple arthrodesis involves three hindfoot joints:

• the subtalar joint,
• the talonavicular joint,
• the calcaneocuboid joint.

These joints are fused to improve stability, reduce pain, and correct abnormal foot biomechanics.

How is the procedure performed?

During surgery, the surgeon removes damaged joint surfaces, prepares the bones for fusion, corrects foot alignment, and stabilises the joints using implants such as screws or fixation systems.

The result is permanent fusion of the affected joints, which helps eliminate painful movement and improve foot stability.

When should arthroscopic triple arthrodesis be considered?

The procedure may be considered in cases of advanced degenerative changes in the hindfoot, foot deformities such as flatfoot deformity, joint instability, post-traumatic conditions, inflammatory joint diseases, and chronic pain affecting walking and daily activities.

It is generally considered when the joints can no longer provide adequate stability and comfortable movement.

What results can be expected after surgery?

The main goal is to reduce or eliminate pain and improve overall foot function.

Patients may experience improved stability while walking, better foot alignment, reduced pain and mechanical overload, and greater comfort during daily activities.

Does fusion of several joints mean I will not be able to walk normally?

No. Although movement in the fused joints is permanently eliminated, other foot structures can partially compensate for the lost motion.

The body gradually adapts to the new alignment, and many patients regain greater stability and comfort than they had before surgery.

Why choose the arthroscopic technique?

The arthroscopic approach minimises the extent of surgical intervention.

Its potential benefits include smaller incisions, reduced soft tissue damage, lower risk of complications, shorter hospital stay, faster recovery compared with traditional open procedures, and precise assessment of joint structures.

Why should treatment not be delayed?

Progressive deformities and instability of the foot tend to worsen over time.

Without appropriate treatment, this may lead to increasing pain, worsening foot alignment, overload of adjacent joints, reduced mobility, reduced walking comfort, and progression of degenerative changes.

What does recovery involve?

Recovery requires patience, protection of the operated limb, and gradual rehabilitation.

Patients usually need to avoid weight-bearing on the operated limb, use crutches, attend follow-up appointments to monitor bone fusion, and gradually increase activity levels.

Rehabilitation is tailored individually and helps the foot adapt to its new biomechanics.

What are the indications for arthroscopic triple arthrodesis?

The procedure may be indicated in cases of advanced hindfoot degeneration, foot deformities, chronic instability, post-traumatic changes, inflammatory joint disease, progressive deformity, chronic pain, overload of adjacent foot structures, and failure of conservative treatment.

How is a patient qualified for surgery?

Qualification is based on an individual orthopaedic assessment and detailed diagnostic evaluation.

This may include specialist consultation, imaging diagnostics, assessment of deformity and instability, gait and biomechanical analysis, evaluation of degenerative joint changes, review of previous treatment, and assessment of functional expectations.

Is arthroscopic triple arthrodesis a first-line treatment?

No. Arthroscopic triple arthrodesis is generally not considered a first-line treatment.

It is usually performed when previous treatment methods no longer provide satisfactory improvement and the main goals are long-term pain relief, correction of foot alignment, and restoration of stability.