Prospective Comparison of Open and Arthroscopic Ankle Arthrodesis Using Validated Outcome Score with Two-Year Minimum Follow-Up (SS-55)

Abstract

Introduction Ankle arthrodesis remains the gold standard treatment for isolated ankle arthritis. Despite improved techniques a 10% nonunion rate, 9% re-operation rate, 5% below knee amputation rate post ankle arthrodesis are reported. Arthroscopic ankle arthrodesis has been recommended by some as a solution to the relatively high rate of complications associated with the open technique. However, to date no other prospective comparative study has been reported to compare the two fusion techniques. Methods Prospective patient data was gathered from consenting patients at baseline, 6 months, one year and two years from two centers, one performing open ankle arthrodesis and one performing arthroscopic arthrodesis. The primary outcome Measures was the Ankle Osteoarthritis Score (AOS). Secondary outcome measures included tourniquet time, length of stay (LOS), non-union rate, and complication rates. A power analysis indicated that 30 patients were required in each group. There were 31 ankles in the open arthrodesis group and 30 ankles in the arthroscopic arthrodesis group. The groups were comparable for age (mean 59.2 vs. 56.0) and BMI (mean 27.9 vs. 29.4). Results The AOS score improved in the open group from 56.8 preoperatively to 33.5 at one year (p Conclusion This was a prospective comparative study of two very similar groups of isolated ankle arthritis using an arthroscopic and open technique of ankle fusion. Both groups showed a significant improvement in symptoms from baseline with a greater change in AOS score and shorter hospital stay in the arthroscopic group.