Resection of calcaneonavicular coalition: Arthroscopic or open approach?

PURPOSE

Calcaneonavicular coalition accounts for more than half of all tarsal coalitions. Resection of calcaneonavicular coalition by an open approach is the standard treatment. Treatment of calcaneonavicular coalition by an arthroscopic approach appears promising. The objective of our study was to compare the clinical outcomes of calcaneonavicular coalition resection by open approach versus arthroscopic approach.

METHODS

A retrospective cohort study was conducted to evaluate 127 patients who underwent a resection of calcaneonavicular coalition from 2009 to 2017. Patients were divided into two groups according to whether an arthroscopic approach or an open approach was used. Demographics, operative parameters, and clinical outcomes (foot and ankle ability measure score, subjective score, and global ankle estimation) were assessed.

RESULTS

Arthroscopic approach was used for 81 patients and open approach for 46 patients. Treatment with arthroscopic approach resulted in a shorter hospital stay (2.6 ± 0.6 days vs 3.0 ± 0.7;  = 0.02) and a longer operative time (24.5 ± 8.1 min vs 20.5 ± 4.2;  < 0.01) than with open approach. The foot and ankle ability measure sports subscale scored significantly higher in the arthroscopic approach group (90.9 vs 77.3;  = 0.003). Revision rate was significantly higher in the arthroscopic approach group (12 (15%)) versus the open approach group (1 (2%)) ( = 0.024). Persistent symptoms ( = 12) were the main reason for revision.

CONCLUSIONS

Arthroscopic treatment of calcaneonavicular coalition is associated with a higher revision rate than the open approach.

LEVEL OF EVIDENCE

Level III-retrospective comparative study.