Triple arthrodesis of the hindfoot, a short term prospective outcome study

The present study was performed to prospectively evaluate the short term results after triple arthrodesis using the validated Foot Function Index (FFI) to measure pain and impairment. Between 1999 and 2002 triple arthrodesis was performed on 81 patients. Four patients had died and 2 patients were not available for follow up leaving 87 fusions in 75 patients with a mean age of 40.5 years (range 14–79) for evaluation. Additional to the objective FFI and AOFAS-hindfoot outcome scores, the subjective outcome comprising patient satisfaction, subjective sense of improvement and shoewear were evaluated with a questionnaire and complications were noted. At a mean follow-up of 21 months, range 12–45 months, clinical assessment was performed by an independent researcher.The FFI 5-point score for pain improved from a mean 39% to a mean 23% (range 100–0% and best score 0%). The score for disability improved from 42 to 30%. The FFI 5-point score could not measure statistically significant differences between the various diagnostic groups.The mean postoperative AOFAS score was 74 points (range 30–94 and best score 94 points). Ninety-one percent of the patients would have the surgery performed again if in the same pre-operative situation.Patient satisfaction was good in 74%, fair in 17% and bad in 8%. The use of custom made shoes could be discontinued in 11 patients while a total of 29 patients (39%) had need for special footwear. The foot function was considered better than pre-operative by 89%. The complication rate in this series was 26%, consisting mostly of minor complications. Triple arthrodesis remains a salvage procedure, but the fusion rate was high with generally only minor complications and after this procedure patients suffer less pain and have better function.