Arthroscopic ankle debridement and fusion: indications, techniques, and results

The use of the arthroscope in arthritis of the ankle has been well described and there is no question that it is a significant part of the armamentarium for the orthopaedic surgeon dealing with these patients. Unfortunately, those patients with advanced arthritis and loss of joint space do not respond well to traditional arthroscopic debridement, removal of loose bodies, debridement and drilling of osteochondral lesions, and removal of anterior osteophytes. These procedures should only be used on those patients with minimal to no degenerative arthritis. Arthroscopic ankle arthrodesis is becoming more of the accepted primary procedure for most cases of arthritis of the ankle, in my opinion. Some varus or valgus tilting of the tibial talar joint can be accepted if clinical alignment is relatively normal. Significant malalignments cannot be corrected with arthroscopic fusion.