Anterior Approach for Ankle Arthrodesis

Area of Science:

• Orthopedic Surgery
• Podiatric Surgery
• Sports Medicine

Background:

• End-stage ankle arthritis significantly impacts patient quality of life.
• Surgical options include ankle arthrodesis (fusion) and arthroplasty (joint replacement).
• Ankle arthrodesis is indicated for persistent pain unresponsive to conservative treatments, especially in cases of posttraumatic arthritis, deformity, or compromised soft tissues.

Purpose of the Study:

• To detail the surgical technique for ankle arthrodesis using an open anterior approach.
• To highlight the use of an anatomic precontoured locking plate for optimal alignment.
• To emphasize critical steps for successful surgical outcomes and long-term fusion.

Main Methods:

• An open anterior extensile incision is utilized, carefully navigating neurovascular structures.
• Osteophytes are removed, and joint surfaces are prepared for fusion.
• Anatomic precontoured locking plates are applied to ensure neutral coronal and sagittal alignment.
• Compression is achieved via the Achilles tension band technique and supplemental transarticular screw fixation.

Main Results:

• The procedure aims for osseous union, with reported union rates ranging from 91% to 96%.
• Successful arthrodesis leads to significant improvement in ankle function and substantial pain relief.
• Long-term follow-up demonstrates sustained clinical improvement and high patient satisfaction, even with radiographic evidence of arthritis progression.

Conclusions:

• Ankle arthrodesis is a successful treatment for end-stage ankle arthritis, particularly when employing meticulous surgical technique and appropriate instrumentation.
• The use of precontoured plates facilitates accurate alignment, crucial for favorable long-term results.
• Patients experience significant functional gains and pain reduction, contributing to high overall satisfaction with the procedure.