Arthroscopic assisted ankle arthrodesis: A retrospective study of 32 cases

The arthroscopic assisted ankle arthrodesis (AAAA) is a minimally invasive procedure for end-stage ankle arthritis with numerous benefits like faster time of union, insignificant blood loss, less morbidity, less infection rate, and less soft tissue complications. A shorter hospital stay decreases the cost and results in early mobilization compared to open methods. We present a retrospective series of 32 patients, who underwent AAAA during a period of 8 years.

Thirty-two patients were reviewed retrospectively from 2008 to 2015. We calculated the Karlsson and Peterson ankle function scoring system pre-operatively and at 3 and 12 months after the surgery, in all the patients. All the patients were operated using arthroscopic denuding of degenerated cartilage followed by percutaneous criss-cross screw fixation through the tibia crossing the ankle joint into the talus.

The mean age at operation time was 43.7 years. Four patients were excluded from the study. 18 were male, and 10 were female patients. All the 28 cases were followed up for a minimum of 1 year (mean 1.7 years). The average time to union was 14 weeks. The complications included four cases requiring removal of a screw for prominence, and one superficial infection. There were 20 (71.4%) patients with excellent, 4 (14.2%) with good, 3 (10.7%) with fair and 1 (3.5%) with poor clinical outcome. The average tourniquet time for the surgery was 70 min. The mean hospital stay was 2 days. The average Karlsson and Peterson's scoring was 32.71 pre-operatively and 74.10 and 89.00 postoperatively measured at 3 months and 1-year follow-up.

With the high incidence of soft-tissue problems and the young age of onset of post-traumatic arthritis, AAAA remains the treatment of choice in most cases with numerous advantages over open technique.