Arthroscopic assisted ankle arthrodesis: A retrospective study of 32 cases

Vaishya, Raju; Azizi, Ahmad Tariq; Agarwal, Amit Kumar; Vijay, Vipul

doi:10.1016/j.jcot.2016.12.002

Cited by 7 publications

(4 citation statements)

References 24 publications

(17 reference statements)

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“…AA can be grouped into open surgery, arthroscopic ankle arthrodesis (AAA), and external fixation fusion. In recent years, AAA has become increasingly popular with foot and ankle surgeons due to its advantages, such as being minimally invasive, having fewer complications (especially skin complications), and its rapid recovery [ 2 – 4 ]. A recent systematic review found that AAA has higher clinical scores, fewer complications, shorter hospital stays, and less bleeding than open ankle fusion, while the overall fusion and reoperation rates of these methods are similar [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis of the initial stability of arthroscopic ankle arthrodesis with three-screw fixation: posteromedial versus posterolateral home-run screw

Wang

et al. 2020

J Orthop Surg Res

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Objective: Arthroscopic ankle arthrodesis (AAA) is a standard surgical method for the treatment of advanced traumatic ankle arthritis and has become more popular due to its advantages. To fix the tibiotalar joint, the use of three percutaneous screws is considered to have better mechanical stability than the use of two screws. However, it is sometimes difficult to insert three screws because they might block each other due to the small area of the tibiotalar joint surface and the large diameter of the screws; few articles illustrate how to insert three screws without the screws disturbing each other. The purpose of this study is to explore possible screw configurations of tripod fixation in arthroscopic ankle arthrodesis that avoid the collision of screws and yield better biomechanical performance. Methods: We used the finite element method to examine the impact of different screw positions and orientations on the biomechanical characteristics of a three-dimensional (3D) ankle model. Maximum and average micromotion, pressure on the articular surface, and von Mises stress values of the tibia and the talus were used to evaluate the initial stability of the ankle. Results: Five kinds of three-screw configurations were identified, and finite element analysis results suggested that configurations with the posteromedial home-run screw presented lower micromotion (maximum, 17.96 ± 7.49 μm versus 22.52 ± 12.8 μm; mean, 4.88 ± 1.89 μm versus 5.19 ± 1.92 μm) (especially configuration 3) and better screw distributions on the articular surface than those with the posterolateral home-run screw. Conclusion: Screw configurations with the posteromedial home-run screw avoid collision and are more biomechanically stable than those with the posterolateral home-run screw. Thus, inserting the home-run screw through the posteromedial approach is recommended for clinical practice.

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Section: Introductionmentioning

confidence: 99%

Finite element analysis of the initial stability of arthroscopic ankle arthrodesis with three-screw fixation: posteromedial versus posterolateral home-run screw

Wang

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…xation fusion. In recent years, AAA has become increasingly popular with foot and ankle surgeons due to its advantages, such as being minimally invasive, having fewer complications (especially skin complications), and its rapid recovery [2][3][4]. A recent systematic review found that AAA has higher clinical scores, fewer complications, shorter hospital stays, and less bleeding than open ankle fusion, while the overall fusion and reoperation rates of these methods are similar [5].…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis of the initial stability of arthroscopic ankle arthrodesis with three-screw fixation: posteromedial versus posterolateral home-run screw

Wang

Zhao

et al. 2020

Preprint

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Objective: Arthroscopic ankle arthrodesis (AAA) is a standard surgical method for the treatment of advanced traumatic ankle arthritis and has become more popular due to its advantages. To fix the tibiotalar joint, the use of three percutaneous screws is considered to have better mechanical stability than the use of two screws. However, it is sometimes difficult to insert three screws because they might block each other due to the small area of the tibiotalar joint surface and the large diameter of the screws; few articles illustrate how to insert three screws without the screws disturbing each other. The purpose of this study is to explore possible screw configurations of tripod fixation in arthroscopic ankle arthrodesis that avoid the collision of screws and yield better biomechanical performance.Methods: We used the finite element method to examine the impact of different screw positions and orientations on the biomechanical characteristics of a three-dimensional (3D) ankle model. Maximum and average micromotion, pressure on the articular surface, and von Mises stress values of the tibia and the talus were used to evaluate the initial stability of the ankle.Results: Five kinds of three-screw configurations were identified, and finite element analysis results suggested that configurations with the posteromedial home-run screw presented lower micromotion (maximum: 17.96 ± 7.49 μm versus 22.52 ± 12.8 μm; mean: 4.88 ± 1.89 μm versus 5.19 ± 1.92 μm) (especially configuration 3) and better screw distributions on the articular surface than those with the posterolateral home-run screw.Conclusion: Screw configurations with the posteromedial home-run screw avoid collision and are more biomechanically stable than those with the posterolateral home-run screw. Thus, inserting the home-run screw through the posteromedial approach is recommended for clinical practice.

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“…In addition, many studies have shown similar complication scans and quality of life between procedures. [1][2][3] Many studies have compared different forms of fixation. 4,5 Screw fixation is the most traditional method, usually made with two crossed screws, one with medial entry and the other with entry.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Screw fixation is the most traditional method, usually made with two crossed screws, one with medial entry and the other with entry. 3,6,7 A third screw was generally added to the anteroposterior axis due to the high incidence of non-consolidations, usually with posterolateral entry into the tibia towards the neck of the talus, known as "home-run" screw ( Figures 1 and 2). [7][8][9][10] The screw is positioned to confront the strong deformation force of the Achilles tendon.…”

Section: Introductionmentioning

confidence: 99%

Pre-Planning Ankle Arthrodesis Using 3d Reconstructed Tomographies

et al. 2020

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Objective: To implement one analysis method of the ankle bone contour that could make a more precise ankle arthrodesis. Methods: Twenty tomographies were submitted to 3D reconstruction. Seven points of anatomic interest for ankle arthrodesis with the three screws technique were marked with a triplannar marker. The median of the position of markers was estimated, and the union of the seven median points allow the construction of one median ankle for that population. Using this median ankle, sizes and angles for the screws position were determined. Results: Two median ankles were reconstructed, left and right. The position of the screw passage were determined considering the anatomical parameters. In the right ankle the lateral to medial screw should enter 4.56 cm and 0.79 above and posterior to lateral malleolus, with one inclination of 17.34° in relation to tibial longitudinal axis; and 0° in relation to tibial axial plane. The position for the other two screws is also described. Conclusion: Our article is the first to presents one precise guide for ankle arthrodesis based on a populational assessment. Level of evidence II, Diagnostic Studies.

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Arthroscopic assisted ankle arthrodesis: A retrospective study of 32 cases

Cited by 7 publications

References 24 publications

Finite element analysis of the initial stability of arthroscopic ankle arthrodesis with three-screw fixation: posteromedial versus posterolateral home-run screw

Finite element analysis of the initial stability of arthroscopic ankle arthrodesis with three-screw fixation: posteromedial versus posterolateral home-run screw

Finite element analysis of the initial stability of arthroscopic ankle arthrodesis with three-screw fixation: posteromedial versus posterolateral home-run screw

Pre-Planning Ankle Arthrodesis Using 3d Reconstructed Tomographies

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