CME OnDemand: 2025 MIS Fusions - Midfoot, Hindfoot, Ankle, Charcot-MIS Fusions

Video Transcription

Video Summary

The webinar on minimally invasive surgery (MIS) fusions in foot and ankle treatment covered techniques from hindfoot to forefoot. Dr. Steve Steinloff discussed the evolution from open to arthroscopic and MIS techniques, highlighting benefits like less soft tissue disruption, fewer complications, and similar or higher fusion rates compared to open surgery. He emphasized biologically friendly practices, such as preservation of soft tissues and limited bone removal, and shared techniques using cartilage removal burrs and dry arthroscopy for joint preparation. Dr. Tyler presented on subtalar, talonavicular, and calcaneocuboid (double and triple) fusions, stressing the importance of positioning, irrigation, fluoroscopy, use of bone grafts, and robust screw fixation for successful outcomes. He advocated for using arthroscopy to verify joint preparation and clearing inflammatory bone paste to reduce heterotopic ossification. Dr. Becky covered midfoot fusions, focusing on MIS Lapidus procedures for bunion correction and TMT joint fusions. She explained approaches, instrumentation, distraction techniques, and fixation strategies, noting improved outcomes, fewer nonunions, and better correction with MIS techniques. The panel discussed strategies for surgeons learning MIS fusions, encouraging starting with easier joints (ankle or Lapidus), using scopes initially, practicing fluoroscopic guidance, and gradually reducing incision size. They highlighted risks like neurovascular injury and technical pitfalls such as inadequate fixation or incomplete joint prep, advising meticulous anatomy knowledge, careful soft tissue handling, protective sleeves, and copious irrigation to avoid complications. Consensus was that MIS fusions, although requiring a learning curve, offer significant patient benefits including less pain, swelling, and wound issues, and ongoing research and education are key to wider adoption.

Asset Subtitle

Moderator: Dr. Alastair Younger, MB ChB MSc ChM FRCSC
Faculty: Rebecca A. Cerrato, MD, Steven D. Steinlauf, MD, Tyler A. Gonzalez, MD, MBA

In this webinar, our expert faculty will demonstrate how modern technology—including cartilage burrs, Shannon burrs, arthroscopy, C-arm radiology, and bone fixation—can be used to fuse joints from the ankle to the midfoot.

At the conclusion of this webinar, you will be able to:
• Describe percutaneous techniques to fuse the ankle, subtalar, and midfoot joints
• Understand the principles of deformity correction through MIS fusions
• Describe the indications, benefits, and specific risks of MIS fusions and how to reduce risks

Meta Tag

Content Type Webinar Recording

Year Published 2025

Keywords

minimally invasive surgery

MIS fusions

foot and ankle treatment

arthroscopic techniques

soft tissue preservation

bone grafts

fluoroscopy guidance

Lapidus procedure

bunion correction

surgical complications