Lateral Hind-Foot Endoscopic Anterolateral/Posterolateral (LEAP) Subtalar Arthrodesis: An Effective Minimally Invasive Technique to Achieve Subtalar Fusion and Deformity Correction

Abstract

Arthrodesis surgery aims to provide relief for chronic joint pain and correct limb alignment by achieving a stable union between articulating bones. The key factors to achieving sound arthrodesis is adequate debridement of arthritic cartilage and creating well-apposed bleeding subchondral bone surfaces without compromising the surrounding soft tissue envelope. Arthroscopic subtalar arthrodesis is technically demanding but provides better visualization of the articular surfaces and is safer for the surrounding soft tissues compared to the open approach. Early published reports of the arthroscopic subtalar arthrodesis from the lateral sinus tarsi approach and posterior approach have shown promising results with high rates of union and less wound healing complications. However, there are concerns about access to all facets of subtalar joint, nerve injury, and deformity correction. In this technique, the article authors describe the lateral endoscopic anterolateral/posterolateral (LEAP) approach for subtalar arthrodesis to improve visualization and access to all facets of the subtalar joint to ensure adequate preparation of apposing surfaces, sound union, and facilitate deformity correction of hind-foot. Strategic portal placement also avoids injury to sural nerve. This is a safe and effective minimally invasive technique for subtalar arthrodesis.