Fusion of the subtalar joint is an accepted method for numerous hindfoot pathologies. Various open techniques have been reported with similar good to excellent results. We designed this prospective analysis to evaluate the efficacy of arthroscopic subtalar fusion to compare the outcome with standard open techniques.

Method: 51 adults with a mean age of 42 years (range 21–75) were operated due to persistant pain and impaired function of the hindfoot unresponsive to symptomatic treatment. Patients were excluded if a significant deformity was present. Scoring was done according to the AOFAS ankle-hindfoot scale preoperatively and at each follow-up exam. A summery of the surgical technique is further given.

Results: 53 arthroscopic subtalar fusions were performed in 51 patients. At final follow-up (minimum 2 years) the AOFAS score improved from 52 preoperatively to 88 points. Non-unions were not observed. Clinical outcome was good and excellent in over 95% of all cases. Progression of degeneration in adjacent joints was minimal. Through the arthroscopic approach intraoperative visualization and preparation of the fusion site is superior to the open technique. Furthermore the clinical outcome supports the use of the endoscopic technique for the treatment of painful osteoarthritis of the hindfoot.