Background
End-stage ankle arthritis severely affects patients’ health-related quality of life. When nonoperative treatments fail, ankle arthrodesis surgery or total ankle arthroplasty can improve pain, function, and health-related quality of life. For patients with isolated end-stage ankle arthritis and minimal deformity outside the ankle requiring osteotomies or fusions, ankle arthrodesis remains the mainstay of operative treatment. Open ankle arthrodesis has been the standard operative treatment for advanced osteoarthritis ankle not responsive to any nonoperative measures, but arthroscopic technique gained high popularity owing to high rate of fusion with a low incidence of complications.
Aim
This study aims to evaluate the role and results of arthroscopic assisted ankle arthrodesis in advanced ankle osteoarthritis (AOS).
Patients and methods
A total of 40 patients with post-traumatic arthritis, primary osteoarthritis, and rheumatoid arthritis were treated by ankle arthroscopic arthrodesis between January 2011 and January 2016 in Suez Canal University Hospital. The ankle was fixed with two cannulated percutaneous screws. The wound healing, complications, postoperative radiographs, and AOS score were evaluated. Both the pain and disability components were used to calculate the total score.
Results
All the cases united, with the average time for union being 12.8±1.19 weeks. The average duration of the surgery was 85.55±17.31 min (67–134). The mean hospital stay postoperatively was 1.2±0.52 days. The mean follow-up period was 36.4±4.38 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. No incidences of deep infections, deep venous thrombosis, or revision surgery were observed. Screws’ length had been changed in four patients because of prominence.
Conclusion
Arthroscopic ankle arthrodesis could be considered as an alternative method for traditional open techniques for the management of severe ankle arthritis.