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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Trephine-based in situ arthrodesis of the central tarsometatarsal joints: Clinical outcomes
Rodrigo Díaz-Fernández1, Nicolás Ruiz-Lozano2, Javier Ortego-Sanz3
1Foot and Ankle Unit, Department of Orthopaedic Surgery and Traumatology. Hospital Vithas Turia, Valencia, Spain; Foot and Ankle Unit, Department of Orthopaedic Surgery and Traumatology. Hospital de Manises, Valencia, Spain; Catholic University of Valencia "Saint Vincent Martyr", Valencia, Spain.
Background:
Osteoarthritis of the second and third tarsometatarsal (TMT) joints is a common cause of midfoot pain. Arthrodesis is a reliable treatment, although optimal joint preparation and fixation remain debated.
Methods:
A retrospective cohort study included 31 feet in 30 patients undergoing isolated or combined second and third TMT arthrodesis for idiopathic osteoarthritis (2016-2022). The technique used trephine-based joint preparation, calcaneal autograft, and nitinol staple fixation. Outcomes included MOXFQ, AOFAS scores, union, and complications.
Results:
Radiographic union was achieved in 95.5% of joints. MOXFQ improved from 33.3 to 9.9 and AOFAS from 37.6 to 77.3 (p < .001). No transfer metatarsalgia was observed. Implant removal occurred in 6.5% and staple breakage in 9.7%.
Conclusion:
This technique provides high union rates, significant functional improvement, and a low complication profile in selected patients.
Level Of Evidence:
Level IV, retrospective case series.
