top of page

The Medial Double Arthrodesis: Over-rated?

Updated: Sep 1, 2021

There is little debate regarding the utility of arthrodesis type procedures in the treatment of end-stage adult acquired flatfoot deformity. Deliberation rages on, however, between proponents of the single-incision medial double versus the traditional dual-incision, triple arthrodesis.

New kid on the block

The single incision medial double has been gaining in popularity over the last decade. Proponents report advantages including fewer wound-healing complications, broad exposure for adequate cartilage resection, a distraction effect on the calcaneocuboid joint, and lower risk for developing ankle valgus, postoperatively.

Hold on now, not so fast

However, Ashlee MacDonald, MD et al. recently conducted an in-vivo study, Single Medial vs 2-Incision Approach for Double Hindfoot Arthrodesis, which compared the cartilage resection between the medial double and triple arthrodesis procedures in eight matched cadaveric specimens. The result: suboptimal debridement for the single incision medial double, particularly with respect to posterior subtalar joint facet and the inferior talar head. The authors also postulated a greater increased risk of postoperative ankle valgus for the single incision approach given that it requires transection of the deltoid ligament for surgical exposure; diametrically different to early reports regarding the utility and benefits of the procedure.

Look for more research comparing the medial and triple arthrodesis procedures in the future; the debate is far from over.

Recent Posts

See All

Joint Line Considerations in TAA

by Vince Vacketta, DPM The importance of restoring the native joint line has been well studied in TKA. As surgeons continue to work to improve total ankle arthroplasty (TAA) results, new research focu

The Dreaded Cyst After Total Ankle Replacement

There is much is to be discovered concerning cysts and total ankle arthroplasty, but we do know is that cysts may lead to aseptic loosening and failure. Hip arthroplasty has connected peri-prosthetic

Preoperative Patient Related Factors and TAR Outcomes

Some patients report poor health-related quality of life after undergoing total hip arthroplasty (THA). Gustafsson et al. conducted a study to determine which factors, at the time of initial diagnosis


FIX Masthead 2000x318 v2.jpg
bottom of page