: Diagnosis and Treatment Options introduction Subtalar osteoarthritis (STOA) is often secondary to chronic ankle sprains or trauma, which seriously affects the quality of life of patients.
: Diagnosis and Treatment Options introduction Subtalar osteoarthritis (STOA) is often secondary to chronic ankle sprains or trauma, which seriously affects the quality of life of patients. As many as 78% of chronic ankle instability patients develop posttraumatic ankle osteoarthritis. The subtalar joint refers to the joint between the talus and the calcaneus.
It is a complex joint involved in human locomotion and plays an important role in shock absorption and propulsion. This joint is designed to provide either a flexible shock absorption construct to the foot or a rigid propulsive one. Every time the subtalar joint is everted, or in valgus, the foot will become a flexible structure because the transverse tarsal joints are unlocked.
When the subtalar joint inverts, the transverse tarsal joints lock themselves, and this provides a rigid lever arm, which is beneficial for locomotion. The subtalar joint is divided by the sinus tarsi, into the talocalcaneonavicular joint anteriorly and talocalcaneal joint posteriorly. This fact explains why just the posterior subtalar facet is visible from the more classic surgical approaches, which do not violate the sinus tarsi.
Physical examination A detailed history and physical examination must be performed when a patient presents with subtalar pain. Difficulty when walking on uneven grounds is a classic symptom, which is taught but not always present. Pain is typically found in the posterolateral aspect of the hindfoot, close and around the sinus tarsi area, or it can radiate from the posterolateral to the posteromedial aspect, including the posterior aspect of the hindfoot.
Rarely, pain will be found at the anterior aspect of the hindfoot, where the ankle joint is assumed to be the source of pain. Motion at the subtalar joint is not easy to examine, because subtalar joint range of motion can be mistaken for ankle joint motion, but contralateral examination can help. Hindfoot alignment is a prerequisite, with the patient standing, from the front and from the posterior aspect.
If you are experiencing symptoms that may be related to subtalar osteoarthritis, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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