Arthroscopic versus open ankle fusion

Abstract

Background Open ankle arthrodesis has been the standard operative treatment for any case of advanced osteoarthritis ankle, but the arthroscopic technique is gained popularity. Patients methods This study was conducted retrospectively reviewing surgeries undertaken between January 2010 and June 2012 for ankles with osteoarthritis. The authors performed 42 ankle arthrodesis procedures on 42 patients. A total of 20 patients were included in group A (arthroscopic ankle fusion), and the other 22 patients were in group B (open anterior ankle fusion). Patients of each group were assessed using preoperative Ankle Osteoarthritis Scale (AOS) score; both the pain and disability components were used to calculate the total score. Results In group A, all the cases were united, with the average time for union being 12.8±1.19 weeks. Of 20 ankles, 65% showed signs of clinical and radiological union by 12 weeks. The early results showed major decrease in AOS from 116±8.6 preoperatively to 19.4±2.3 postoperatively. This shows that the arthroscopic fusion was able to decrease the score by an average of 97.7±10.2 points. Long-term follow-up was 71.8±8.6 months and showed that the early postoperative results did not change significantly: 55% of patients still had excellent outcome, and four patients (20%) develop subtalar osteoarthritis. In group B, 21 cases (>95%) were united, with an average time to union of 13.3±5.6 weeks. The early results showed major decrease in AOS from 114±7.24 preoperatively to 26.68±6.95 postoperatively. This shows that the open anterior fusion was able to decrease the score by an average of 88.2±7.2 points. Long-term follow up was 83.5±12 months and showed that the early postoperative results changed significantly, where nine patients (40.9%) still had excellent outcome, and nine patients (40.9%) developed subtalar osteoarthritis and four of them needed further subtalar fusion. Conclusion This was a comparative study that involved two groups with two techniques of ankle fusion, showing early and late results. There was no significant difference between both the groups regarding early results, but long-term follow-up clarifies the advantages of arthroscopic fusion technique.