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[Long-term development of tibio-astragalus arthrodesis]
Summary
Ankle fusion surgery using Charnley compression had a 42% complication rate and satisfactory results in 75% of patients. Post-fusion arthritis in adjacent joints is a long-term concern.
Area of Science:
- Orthopedic Surgery
- Podiatric Medicine
- Musculoskeletal Research
Background:
- Ankle arthrodesis is a common procedure for end-stage ankle arthritis.
- Post-traumatic arthritis is a primary indication for ankle fusion.
- Long-term outcomes and complications require ongoing evaluation.
Purpose of the Study:
- To review outcomes of ankle arthrodesis using a specific surgical technique.
- To assess complication rates and clinical satisfaction after ankle fusion.
- To evaluate radiological changes in adjacent joints post-arthrodesis.
Main Methods:
- Retrospective review of 28 ankle arthrodeses.
- Standardized surgical technique involving lateral malleolus osteotomy and Charnley compression device fixation.
- Mean follow-up of 9.5 years.
Main Results:
- 42% complication rate, including infections and nerve lesions.
- 17.5% revision rate, primarily for malposition.
- 75% satisfactory clinical outcomes, 25% poor outcomes.
- Significant radiological changes (pre-arthritic appearance) noted in subtalar and midtarsal joints, more pronounced with hindfoot equinus.
Conclusions:
- Ankle fusion with Charnley compression has a notable complication rate and potential for post-fusion arthritis.
- Internal fixation with screws may be preferable.
- Future potential for ankle arthroplasty warrants consideration.