Richard D Ferkel1, Michael Hewitt. 1. Southern California Orthopaedic Institute, 6815 Noble Avenue, Van Nuys, CA 91405, USA. ferkel@scoi.com
Abstract
BACKGROUND: More than 40 open procedures have been described for ankle arthrodesis, most with high complication rates. Since its description in 1983, arthroscopic ankle arthrodesis has become a viable option in selected patients. With one of the largest series in the literature, the purpose of the paper was to analyze the results of arthroscopic ankle arthrodesis at our institution. METHODS: Between 1989 and 2002, 35 patients with end-stage ankle arthritis underwent arthroscopic ankle arthrodesis. The average followup was 72 months, with a range of 24 to 167 months. Patients returned for a clinical and radiolographic evaluation using the grading systems of Mazur and Morgan. All patients had preoperative and postoperative radiographic evaluation to assess fusion. Indications for arthroscopic ankle arthrodesis included failure of at least 6 months of conservative treatment, minimal or mild correctable deformity in the coronal plane, and no active infections. RESULTS: The overall fusion rate was 97% (34 of 35 patients). The average time to fusion was 11.8 weeks, with a range of 8 to 18 weeks. There were 74% good to excellent results by the Mazur grading system and 83% by the Morgan system. There were no infections or neurovascular injuries. In the three patients who required bone stimulators for delayed unions, fusion occurred in two, and one had a nonunion. Eleven patients had screws removed because of pain at an average of 11 months after the initial surgery. CONCLUSION: Our study demonstrated a high fusion rate with minimal complications for arthroscopic ankle arthrodesis.
BACKGROUND: More than 40 open procedures have been described for ankle arthrodesis, most with high complication rates. Since its description in 1983, arthroscopic ankle arthrodesis has become a viable option in selected patients. With one of the largest series in the literature, the purpose of the paper was to analyze the results of arthroscopic ankle arthrodesis at our institution. METHODS: Between 1989 and 2002, 35 patients with end-stage ankle arthritis underwent arthroscopic ankle arthrodesis. The average followup was 72 months, with a range of 24 to 167 months. Patients returned for a clinical and radiolographic evaluation using the grading systems of Mazur and Morgan. All patients had preoperative and postoperative radiographic evaluation to assess fusion. Indications for arthroscopic ankle arthrodesis included failure of at least 6 months of conservative treatment, minimal or mild correctable deformity in the coronal plane, and no active infections. RESULTS: The overall fusion rate was 97% (34 of 35 patients). The average time to fusion was 11.8 weeks, with a range of 8 to 18 weeks. There were 74% good to excellent results by the Mazur grading system and 83% by the Morgan system. There were no infections or neurovascular injuries. In the three patients who required bone stimulators for delayed unions, fusion occurred in two, and one had a nonunion. Eleven patients had screws removed because of pain at an average of 11 months after the initial surgery. CONCLUSION: Our study demonstrated a high fusion rate with minimal complications for arthroscopic ankle arthrodesis.
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