Arthroscopic ankle arthrodesis: Are results reproducible irrespective of pre-operative deformity?

Dannawi, Zaher; Nawabi, Danyal H.; Patel, A.; Leong, Julian; Moore, David

doi:10.1016/j.fas.2010.12.004

Cited by 82 publications

(61 citation statements)

References 17 publications

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“…The number of outpatient arthrodeses performed with arthroscopic assistance increased by 858% [21]. The capability of treating ankles with marked deformity, slightly shorter time of union, reduced complication rates, and lower costs compared with open surgery make arthroscopic ankle fusion a safe and reliable technique [10, 12, 22–25]. …”

Section: Discussionmentioning

confidence: 99%

Arthroscopic arthrodesis for ankle arthritis without bone graft

2016

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BackgroundAnkle arthrodesis is considered by many to be the standard operative treatment for end-stage ankle arthritis. The purpose of this study was to perform a new technique for ankle joint surface and determine the outcome for the union rates of ankle arthroscopic arthrodesis.MethodsA total of 68 patients with posttraumatic arthritis, primary osteoarthritis, and rheumatoid arthritis were treated by ankle arthroscopic arthrodesis between May 2007 and December 2012. Our surgical indication was deformity less than 15° measured by weight-bearing radiographs. Firstly, the remaining articular cartilage was removed with different curettes and shavers. Then, the new technique (microfracture) was done at tibiotalar surfaces. Finally, the ankle was fixed with two cannulated percutaneous screws. The wound healing, complications, postoperative radiographs, and American Orthopaedic Foot and Ankle Society (AOFAS) score were evaluated.ResultsThe average follow-up time was 32 months (range 25–58 months). There was no bone grafting, and a fusion rate of 100% was achieved. The average fusion time was 12.1 weeks. One patient developed superficial infection at 2 weeks postoperatively and was cured by nonsurgical treatment. No deep infections, deep venous thrombosis, or revision surgery were observed. Screws had been removed in four patients because of prominence. One patient had fusion in the subtalar joint because of arthritis at 5 years postoperatively. At the last follow-up, radiographic signs of developed or progressing arthritis were observed in nine patients at subtalar joint and in four patients at talonavicular joint. At 1-year follow-up, the mean AOFAS ankle/hindfoot score had increased to 84 from a mean preoperative value of 38 (P < 0.01).ConclusionsArthroscopic arthrodesis provides surgeons with an alternative to traditional open techniques for the management of severe ankle arthritis. Our data show that preparation of the joint surface with microfracture is an effective technique to increase the union rate of arthroscopic ankle arthrodesis, while bone graft and other promoting substances are not necessary to be routinely used.Electronic supplementary materialThe online version of this article (doi:10.1186/s13018-016-0490-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic arthrodesis for ankle arthritis without bone graft

2016

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“…These result in reduced postoperative pain and shorter hospital stay. [5,[9][10][11] Despite the significant advantages, arthroscopic ankle arthrodesis has a long learning curve and is technically demanding. Several problems have become more evident with increased use.…”

Section: Discussionmentioning

confidence: 99%

“…[5] Despite this, arthroscopic ankle arthrodesis can be used to correct the angles sufficiently, including cases of advanced varus and valgus deformities. [10] In the current study, sufficient correction was established in the coronal plane. The preoperative coronal plane tibiotalar angle of 6.6±5.5° was reduced to 2.3±2.1° postoperatively.…”

Section: Acutrakmentioning

confidence: 99%

Is the use of headless compression screws appropriate in arthroscopic ankle arthrodesis?

Öçgüder¹,

Fırat²,

Özdemir

et al. 2017

Eklem Hastalik Cerrahisi

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“…intertarsal fusion, [1][2][3] total ankle arthroplasty, 4,5 and a combination of these techniques. Ankle arthrodesis is superior to ankle arthroplasty and regarded as the gold standard, with a union rate of 85 to 100%.…”

mentioning

confidence: 99%

Transfibular Ankle Arthrodesis Using Burring, Curettage, Multiple Drilling, and Fixation with Two Retrograde Screws through a Single Lateral Incision

Lee

Min

Kim

et al. 2016

J Orthop Surg (Hong Kong)

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Purpose. To review the outcome of 23 ankle arthrodeses using burring, curettage, multiple drilling, and fixation with 2 retrograde screws through a single lateral incision. Methods. Records of 22 consecutive patients aged 39 to 79 (mean, 62.4) years who underwent 23 ankle arthrodeses for end-stage ankle arthritis were reviewed. Through a single lateral incision, articular cartilage was removed using burring and curettage, and multiple holes were drilled using a Kirschner wire, followed by fixation with 2 retrograde screws. The resected distal fibula was fixed to the distal part of the talus and tibia. The position of the ankle and subtalar joint arthrosis was assessed by 2 orthopaedic specialists. Pre-and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) scores were evaluated. Results. The mean operating time was 122 minutes. The mean follow-up period was 41 months. The mean postoperative ankle alignment was suboptimal: 2.7ºTransfibular ankle arthrodesis using burring, curettage, multiple drilling, and fixation with two retrograde screws through a single lateral incision varus, 6.7º plantar flexion, and 2.9º internal rotation. The mean AOFAS score improved from 30 to 71 (p<0.01). The postoperative varus ankle alignment was not associated with the AOFAS score (r= -0.13, p=0.569). Of the 23 cases, one was nonunion and 22 achieved bone union after a mean of 5.4 (range, 2-16) months; 3 of them were delayed union. Despite bone union, 7 patients complained of persistent pain; 4 of them had progressive arthrosis of the adjacent subtalar joints (n=2) or subtalar and talonavicular joints (n=2). Conclusion. Ankle arthrodesis using burring, curettage, multiple drilling, and fixation with 2 retrograde screws achieved a high union rate and acceptable functional score without serious complications.

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Arthroscopic ankle arthrodesis: Are results reproducible irrespective of pre-operative deformity?

Cited by 82 publications

References 17 publications

Arthroscopic arthrodesis for ankle arthritis without bone graft

Arthroscopic arthrodesis for ankle arthritis without bone graft

Is the use of headless compression screws appropriate in arthroscopic ankle arthrodesis?

Transfibular Ankle Arthrodesis Using Burring, Curettage, Multiple Drilling, and Fixation with Two Retrograde Screws through a Single Lateral Incision

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