Journal of Foot and Ankle Surgery (Asia Pacific)

Register      Login

VOLUME 9 , ISSUE S1 ( August, 2022 ) > List of Articles

RESEARCH ARTICLE

Talus Avascular Necrosis: Demographics, Epidemiology, and Activity Level

Akhil Sharma, Urvi J Patel, Rishin J Kadakia, Aman Chopra, Selene Parekh

Keywords : Outcome studies, Sports, Trauma

Citation Information :

DOI: 10.5005/jp-journals-10040-1232

License: CC BY-NC 4.0

Published Online: 29-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Background: The talus is predisposed to avascular necrosis (AVN) due to its intraosseous blood supply and extraosseous arterial sources. Currently, limited information exists on the patients’ functional level with regard to daily activity and their subjective sense of functioning. This work aimed to better appreciate the functional level of patients after surgery for talar AVN. Materials and Methods: Patients were identified through a publicly available online support group for talar AVN. A 36-question survey was distributed to determine baseline demographics, epidemiology of talar AVN, and functional status. A total of 96 patients completed the anonymous survey, and only fully completed surveys were included. Results: The majority of patients who responded were female (87/96 = 91%) and were diagnosed with talar AVN as adults. The most common etiology was trauma (35/96 = 37%). Most patients started with nonoperative treatment—however, the majority of patients ultimately underwent operative intervention (63/96 = 66%). Patients reported a functional activity level of 52% in regard to activities of daily living (ADLs). The functional activity level pertaining to sports-related activities was half that of ADLs (27%). Conclusion: Patients with talar AVN present with significant pain and limitation that negatively impacts their daily functioning. Our results demonstrate that patients report at least 50% loss in ability to function with regard to ADLs and almost a 75% loss in sporting-related activities. These substantial losses in the subjective sense of functioning illustrate how difficult this problem really is for patients. Providers must be cognizant of functional limitations associated with talar AVN when counseling patients. Level of evidence: III


PDF Share
  1. Pearce DH, Mongiardi CN, Fornasier VL, et al. Avascular necrosis of the talus: a pictorial essay. Radiographics 2005;25(2):399–410. DOI: 10.1148/rg.252045709
  2. Dhillon MS, Rana B, Panda I, et al. Management options in avascular necrosis of talus. Indian J Orthop 2018;52(3):284–296. DOI: 10.4103/ortho.IJOrtho_608_17
  3. Gross CE, Haughom B, Chahal J, et al. Treatments for avascular necrosis of the talus: a systematic review. Foot Ankle Spec 2014;7(5):387–397. DOI: 10.1177/1938640014521831
  4. Mont MA, Schon LC, Hungerford MW, et al. Avascular necrosis of the talus treated by core decompression. J Bone Joint Surg Br 1996;78(5):827–830.
  5. Abd-Ella MM, Galhoum A, Abdelrahman AF, et al. Management of nonunited talar fractures with avascular necrosis by resection of necrotic bone, bone grafting, and fusion with an intramedullary nail. Foot Ankle Int 2017;38(8):879–884. DOI: 10.1177/1071100717709574
  6. Canale ST, Kelly FBJ. Fractures of the neck of the talus. Long-term evaluation of seventy-one cases. J Bone Joint Surg Am 1978;60(2): 143–156. DOI: 10.2106/00004623-197860020-00001
  7. Mindell ER, Cisek EE, Kartalin G, et al. Late results of injuries to the talus: analysis of forty cases. JBJS 1963;45(2).
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.