Abstract
PurposeThe presented study was performed to evaluate the midterm clinical and radiological results and complication rates of the first 40 patients with an ankle fusion through a posterior arthroscopic approach.MethodsForty consecutive patients with end-stage post-traumatic ankle osteoarthritis were treated with posterior arthroscopic ankle fusion. All patients were assessed clinically as well as radiologically with a minimum follow-up of 2 years. The Foot and Ankle Ability Measure (FAAM) and Foot Function Index (FFI) were used to assess clinical improvement.ResultsClinical fusion was achieved in 40 patients within 3 months (100 %), and radiological fusion was achieved in 40 patients at 12 months. Two screw mal-placements occurred. Both complications were solved following revision surgery. A significant improvement was noted for both the FAAM [median 38 (range 17–56) to 63 (range 9–84)] and FFI scores [median 66 (range 31–89) to 32 (range 11–98)] for all 40 patients.ConclusionThe posterior arthroscopic ankle fusion is an effective and safe treatment option for end-stage post-traumatic ankle osteoarthritis at midterm follow-up.Level of evidenceProspective cohort study, Level IV.
Highlights
Several methods have been described for fusion of the ankle joint
Arthroscopy assisted fusion is becoming more popular with equivalent high union rates, but lower complications, as compared to open surgery [5, 19, 21]
The main finding of this study is that an ankle fusion through a posterior arthroscopic approach is an effective and safe technique to treat end-stage post-traumatic ankle OA with an union rate of 100 % in the first 40 cases
Summary
Several methods have been described for fusion of the ankle joint. Secure fusion can be accomplished arthroscopically, by open surgery or by using a so-called mini-open technique [5, 9, 17,18,19]. An open procedure might allow for a better correction of mal-alignment of the hindfoot, when significant deformity is present. Recent evidence supports the use of arthroscopic techniques for more markedly deformed ankles as well [6]. Arthroscopy assisted fusion is becoming more popular with equivalent high union rates, but lower complications, as compared to open surgery [5, 19, 21]. The posterior ankle arthroscopic technique, known as hindfoot endoscopy, is safe and reliable [7, 10]. Prior to commencing the presented technique in our patients, an anatomical study was performed to evaluate its safety and efficiency [10]
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