Open versus arthroscopic ankle arthrodesis in high-risk patients: a comparative study

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Surgical Innovation

Background:

• Ankle arthrodesis is a common procedure for end-stage ankle arthritis.
• Traditional open arthrodesis carries risks, particularly in high-risk patient populations.
• Minimally invasive techniques like arthroscopic ankle arthrodesis are emerging as alternatives.

Purpose of the Study:

• To compare the efficacy and safety of open versus arthroscopic ankle arthrodesis.
• To evaluate outcomes in patients at high risk for complications, such as non-union.
• To assess fusion rates, complication rates, and clinical outcomes.

Main Methods:

• Retrospective comparative analysis of 44 ankle fusions (23 open, 21 arthroscopic).
• Inclusion of patients at high risk for non-union.
• Assessment of radiographic union, time to union, operative time, and complications.
• Clinical outcome evaluation using the AOFAS Ankle-Hindfoot Scale, FFI, and VAS pain scores.

Main Results:

• Arthroscopic ankle arthrodesis demonstrated a significantly higher union rate (90.5% vs. 65.2%).
• The complication rate was significantly lower in the arthroscopic group (14.3% vs. 47.8%).
• Arthroscopic procedures led to better pain control (VAS scores), with no significant differences in operative time or functional scores (AOFAS, FFI).

Conclusions:

• Arthroscopic ankle arthrodesis is a favorable option for high-risk patients requiring ankle fusion.
• It offers improved union rates and reduced complication rates compared to open surgery.
• This technique enhances pain management and functional recovery in challenging cases.