Percutaneous arthrodesis

Hemiarthroplasty in the Treatment of Hallux Rigidus

“…In a clinical study, Lombardi 32 followed 21 cases, treated by arthrodesis, for an average of 28 months. The AOFAS scores rose from 39 to 75.…”

The Mini-Arthrotomy Ankle Arthrodesis: A Review of Nine Cases

“…Still further, a strong subchondral bone surface area also contributes to the stability of this arthrodesis technique. These concepts related to arthrodesis were tested in Lauge-Pedersen et al's studies (23)(24)(25)(26)(27)(28), in which they fused rabbit joints with percutaneous fixation. They felt that depletion of the synovial fluid was an important factor related to the degeneration of cartilage and the progression of trabecular bridging.…”

(i) The principles of foot and ankle arthrodesis

“…Internal fixation with screws is likely to be the most stable construct for ankle arthrodesis, particularly when the screws are crossed just above the joint line in the tibia 37 (Figure 5b). Our preference, however, is to use two parallel partially-threaded cannulated cancellous screws with washers, ensuring both screw threads entirely cross the joint-line to obtain adequate compression of the fusion, (Figures 5c and 6).…”

“…Maintenance of natural joint shape and congruity has been shown to be more biomechanically stable than flat arthrodesis cuts. 37 Following decortication, the exposed cancellous surfaces should be ''feathered'', ''fish-scaled'' or ''petalised'' in two perpendicular directions to create pits and furrows thereby maximising the area of interdigitation between surfaces and exposing pluripotent marrow-derived stem cells (Figure 4). All decortication and petalisation should be carried out with sharp chisels wherever possible: the use of saws and power burrs should, in our opinion, be avoided due to the generation of high localised temperatures which are known to impair bone healing in animal models.…”

“…Thorough decortication may not be necessary for certain patients, Percutaneous and spontaneous arthrodesis is possible in the joint which has undergone chondrolysis as a result of immobility or in the rheumatoid joint as a result of synovitis. 37 However, thorough joint preparation by meticulous removal of all cartilage and feathering in two perpendicular directions provides a better environment for successful bony healing.…”