Abstract
Purpose: Methods: Evaluation of the results of arthroscopic ankle arthrodesis, performed in 49 consecutive patients (52 ankles), with disabling ankle arthritis, between 08/1998 and 12/2004. Thirty ankles had no significant deformity (group A), whereas 22 ankles had a varus or valgus deformity greater than 10° (mean 21.7°, max 45°) (group B). Mean age in groups A and B was 49.7 and 57.5 years respectively (p=0.15). The primary diagnosis in groups A and B was post-traumatic arthritis in 66% and 27% and idiopathic osteoarthritis in 17% and 59%, respectively. Average hospital stay was 3.63 and 3.68 days in groups A and B respectively (p=0.96). Postoperative treatment included ankle immobilization for 3 months. Progressive weight-bearing was initiated at two weeks. Mean follow-up was 14.9 months (range 6–60).
Results: No infections or neurovascular problems occurred. Fusion occurred in 29/30 cases in group A at an average time of 11.52±5.2 weeks and in 21/22 patients at 11.67±2.3 weeks in group B (p=0.89). Not planned surgical procedures were required in eight cases (15.4%). Symptomatic arthritis from the adjacent joints developed in three cases during the follow-up period. The arthrodesis position angle measured in the sagittal plane from the lateral post-operative plane film averaged 105°±3° and 103°±6° in groups A and B respectively (p=0.27). The outcome in groups A and B was graded as very good in 73% and 72.7%, fair in 23% and 22.7% and poor in one case in each group, respectively (p=0.26).
Conclusions: The arthroscopic technique offers a high fusion rate, decreased time to fusion, short hospital stay and absence of limb-threatening complications. Deformity correction can be attempted with equally good results.
Correspondence should be addressed to the Honorary Secretary, BOFSS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
