Arthroscopic Ankle Arthrodesis

Abstract

Background: Arthroscopic arthrodesis has been used mainly for in situ fusion of arthritic ankles without deformity. This paper presents the application of arthroscopic arthrodesis of ankles with marked deformity. Methods: The results of 78 consecutive cases of arthroscopic ankle arthrodeses, performed in 74 patients, were retrospectively evaluated. Forty-eight ankles had minor deformity (group A), whereas 30 ankles had a varus or valgus deformity of more than 15 degrees (maximum 45 degrees) (group B). The average hospital stay was 3.8 and 3.4 days in groups A and B, respectively ( p = 0.74). Postoperative treatment included ankle immobilization for 3 months. Progressive weightbearing was initiated at 2 weeks. Mean followup was 21.1 months. Results: Fusion occurred in 47 of 48 (97.9%) ankles in group A at an average time of 13.1 ± 5.8 weeks and in 29 of 30 (96.7%) ankles at 11.6 ± 2.4 weeks in group B ( p = 0.19). Unplanned operative procedures were required in 11 ankles (14.1%). One superficial wound infection occurred. Symptomatic arthritis from the adjacent joints developed in six ankles (7.7%). Postoperative ankle alignment in the frontal plane averaged 0.7 and 0.4 degrees of valgus ( p = 0.41), whereas the sagittal plane angle averaged 106 ± 4 degrees and 104.5 ± 7 degrees in groups A and B, respectively ( p = 0.22). The outcome was graded as very good in 79.2% (38 feet) in group A and 80% (24 feet) in group B, fair in 18.8% (9 feet) in group A and 16.7% (5 feet) in group B and poor in one ankle in each group ( p = 0.68). Conclusions: The arthroscopic technique offered high fusion rates and low morbidity. Deformity correction was achieved with good results.

Arthroscopic ankle arthrodesis: a review

“…Time to fusion, complications, and post-operative tibiotalar axis were recorded. A high fusion rate (97 %) and correction of the malalignment were obtained with the arthroscopic technique in both low and high grade deformities [18]. Similar results were described by Dannawi et al, with no significant differences in terms of fusion rate and patient satisfaction between high and low grade deformity groups.…”

“…The literature reported a mean time to union of 12 weeks after surgery (ranging from 6 to 40) [17,29,30], with a union rate ranging from 85 % to 97 % [17, 18, 19••, 29-31]. Although a shorter time to union is usually described in the literature for arthroscopic ankle arthrodesis compared with open surgery [6,17,31,32] [17,18,30]. Other studies also reported good to excellent results in 86-95 % of the patients treated arthroscopically [5,6].…”

“…With regard to early onset of osteoarthritis in adjacent joints, subtalar degenerative changes are often described in patients with ankle fusion [1,8,9,17,18]. Although some authors described a 6.8 % incidence of subsequent subtalar or talonavicular fusion [1,17], most of the patients seem to be satisfied with ankle fusion without the need for further surgeries [8,9].…”

Arthroscopic assisted ankle arthrodesis: A retrospective study of 32 cases

“…Winson (Table 4). 1,16,21,22 The results of total ankle replacement are improving day by day but still its long-term survivorship is not very good. With the high incidence of soft-tissue problems and the young age of onset of post-traumatic arthritis, on the basis of clinical outcome in our study we believe that an arthrodesis remains the treatment of choice in most cases.…”

Therapie der posttraumatischen Arthrose am Sprunggelenk

“…Gene ration berichteten sie über eine Gesamt komplikationsrate von 29,5 % bei einer Überlebensrate nach 10 Jahren von 87,6 %. Die Hauptprobleme waren Sinterung der Prothese (10,7 %), aseptische Lockerungen (8,7 %), intraoperative Frakturen (8,1 %) und Wundheilungsprobleme (6,6 % Insgesamt wird bei 75-95 % der ope rierten Patienten über gute bis sehr gute Ergebnisse berichtet [11,17,23]. Die Fä higkeit, selbst Auto zu fahren, erlangen alle Patienten wieder, die dies präope rativ konnten.…”