Summary

Ankle fusion was operated by arthroscopy which had many advantages, such as, less traumatic, no incision incision and fusion failure and no significant complications.

Abstract

Purpose:: To explore the value and recent curative effect of ankle fusion by arthroscopy.

Methods

From January 2014 to March 2016, a total of 10 cases , 5 cases of traumatic arthritis, 4cases of degenerative osteoarthritis, 1 case of rheumatoid arthritis. All patients had ankle sustained pain and flexion and extension by limited with more than half a year. We can found ankle clearance narrow, cartilage surface not sleek, marginal osteophyte hyperplasia and sclerosis of subchondral bone from the DR. We can found ankle effusion, ankle clearance narrow, stripped, cartilage deficiency and marginal osteophyte hyperplasia from the MRI. Under the arthroscope to remove hyperplastic synovial membrane of ankle, and we can deal with the cartilage, marginal osteophyte hyperplasia and sclerosis of subchondral bone. We implanted into the two screws from the front to ankle to fusion area, with the long axis of the tibia into 30 °. We did the bone graft when implanting into the two screws with special tools, and give enough pressure to implante cancellous bone. We implanted into the third screw from the front to ankle to fusion area, which can enhance the stability of sagittal plane. We used American Orthopaedic Foot and Ankle Society (AOFAS) scores and visual analogue scale (VAS) scores to evaluate the function and pain.

Results

10 patients were followed up and ankle fusion. Mean time of followed up was 1 year and 2 months. Ankle synostosis time was from 12 to 16 weeks of the postoperative which evaluated by DR. We did not found the early complications, such as, incision incision, infection and fusion failure. The American Orthopaedic Foot and Ankle Society (AOFAS) scores from 51.3±12.7(preoperative) to 82.4±11.6(postoperative), difference with statistical significance. (P < 0.05). VAS scores from 7±2.6 (preoperative) to 2±1.3(postoperative), difference with statistical significance (P < 0.05).

Conclusion

Ankle fusion was operated by arthroscopy which had many advantages, such as, less traumatic, no incision incision and fusion failure and no significant complications. It did not destroy the blood supply to bone and maintained normal anatomy and function of ankle. So, if it was necessary to replace the ankle, we can do it in the future.