Subtalar Arthritis

  What is subtalar arthritis?

The subtalar joint sits between the talus and heel bone and allows the foot to adapt to uneven surfaces.

Arthritis can develop following injury, particularly a previous heel fracture, or because of wear and tear or inflammatory arthritis.

What symptoms and signs might I experience?

• Pain below or around the ankle.
• Pain on uneven ground.
• Difficulty walking on slopes.
• Stiffness.
• Reduced side-to-side movement.
• Swelling.
• Pain when moving the heel from side to side.

How is it diagnosed?

Assessment includes clinical examination and X-rays.

A CT scan can provide detailed information about the subtalar joint, particularly when planning surgery.

An injection into the joint can sometimes help identify whether it is the source of symptoms.

How is it treated without surgery?

Treatment may include:

• Supportive footwear.
• Orthotics.
• Bracing.
• Physiotherapy.
• Activity modification.
• Walking aids where appropriate.
• Pain relief.
• Injection into the subtalar joint.

When might surgery be considered?

Surgery may be considered when severe symptoms persist despite appropriate treatment.

What might surgery involve?

The most common operation is subtalar fusion.

The damaged joint surfaces are removed and the bones are fixed together until they heal.

This aims to remove painful movement from the joint but does reduce side-to-side movement of the hindfoot.

What is recovery like?

A period of non-weight-bearing for 6 weeks is usually required while the fusion heals, followed by gradual rehabilitation.