Arthrodesis of the ankle joint in septic osteoarthritis: six years long term outcomes in authors' personal experience.

Abstract

Our goal was to evaluate the long-term clinical outcome of ankle arthrodesis, obtained by an extramedullary internal fixation with or without bone-grafting in the treatment of ankle' septic arthritis. All patients treated with arthrodesis by extramedullary internal fixation for septic arthritis of the ankle joint between January 2011 and December 2016 in the same hospital were included in our retrospective study. Patients were followed-up for a minimum of two years. To evaluate the quality of life, each patient filled in a short form of the physical and mental health summary scale and a visual analogue scale for pain. For the functional evaluation, the American Orthophaedic Foot and Ankle Society Score was used. Demographics and clinical data, including perioperative and postoperative complications, were evaluated. From January 2011 to December 2016, we performed 57 arthrodeses of the ankle joint with cannulated screws in 52 patients. Mean age was 52 years old. 48 patients (92%) had post-traumatic septic arthritis. The most frequently isolated pathogens were Staphylococcus aureus and Pseudomonas aeruginosa. 48% of patients reported a postoperative complication after three months; the most commonly reported complications were weight bearing ankle-foot pain (27%) and surgical wound dehiscence (12.25%). Nonunion was reported only in 8.75% of cases. Ankle arthrodesis could allow painless gait, improving patients life quality, even after long-term follow-up, and is, therefore, a solution to be considered in patients affected by septic arthritis.