Description
INTRODUCTION AND OBJECTIVES
Posttraumatic ankle osteoarthritis frequently is a disabling condition with a negative influence on a patients quality of life. One of the possible treatment options is to fuse the ankle joint, thereby regaining the ability to mobilize without the pain. The presently available anterior arthroscopic techniques to fuse the ankle joint report less complications as compared to open surgery, however still in up to 9 % of the patients a non-union occurs. In 2014 a novel technique was introduced to fuse the ankle joint through a posterior ankle arthroscopic approach. The presented study was performed to evaluate the midterm clinical and radiological results and complication rates of the first forty patients with an ankle fusion through a posterior arthroscopic approach.
METHODS
Forty consecutive patients with end-stage posttraumatic ankle osteoarthritis (Figure 1 A/B) were treated with a posterior arthroscopic ankle fusion. All patients were prospectively assessed, both clinically as well as radiographically with a minimum follow-up of two years. Clinical union was based on lack of ankle motion and pain-free weight bearing, whereas radiographic union was defined as bridging trabeculae in two radiographic planes. The Foot and Ankle Ability Measure (FAAM) and Foot Function Index (FFI) were used to assess clinical improvement. Single T-test for repeated measures was used for statistical analysis, significance levels of p< 0,05 were used.
RESULTS
The average follow-up was 43 months (range 24-66). The mean age was 51 years old (range 21 – 80). Clinical fusion was achieved in 40 patients within three months (100%), radiographic fusion was achieved in 40 patients at 12 months (Figure 1 C/D). Two screw mal-placements occurred, which were solved following revision surgery. There were no postoperative infections or transient or permanent neurovascular injuries. A significant improvement was noted for both the FAAM (mean 35 (SD 13) to 56 (SD 24) and FFI scores (mean 64 (SD 18) to 39 (SD 28) for all 40 patients.
CONCLUSION
The posterior arthroscopic ankle fusion is an effective and safe treatment option for end stage posttraumatic ankle osteoarthritis at midterm follow-up. The presented union rates at midterm follow-up compare favorably to the up to present available results in literature.
