2015 ISAKOS Biennial Congress ePoster #138

Arthroscopic Ankle Arthrodesis Using Two Standard Anterior Portals

Daniel Saraiva, MD, Porto PORTUGAL
Andre Costa, MD, Porto PORTUGAL
Tiago Torres, MD, Porto PORTUGAL
Filipe Santos, MD, Porto PORTUGAL
Ricardo Santos Pereira, MD, Porto PORTUGAL
André Sarmento, MD, Porto, Seleccione PORTUGAL
Paulo Jorge Carvalho, MD, Porto PORTUGAL
Pedro Canela, MD, Porto PORTUGAL
Campos Lemos, MD, Porto PORTUGAL

CHVNGaia/Espinho, V.N.Gaia, Porto, PORTUGAL

FDA Status Not Applicable

Summary: Arthroscopic ankle arthrodesis using two standard anterior portals has shown to be a successful procedure in achieving ankle fusion on end-stage osteoarthritic ankles, with high consolidation and low complication rates and showing high impact in the quality of life of the patients.

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Abstract:

Arthroscopic ankle arthrodesis has shown to be a successful procedure in achieving ankle fusion on end-stage osteoarthritic ankles, even in patients with very narrow joint space, and has become the gold standard in achieving ankle fusion. It is attractive to the orthopedic surgeon since it's a minimally invasive procedure, allowing for a quicker recovery, while avoiding the often necessary bone grafting in the classic open procedures.

We present a retrospective study of 43 patients, with a mean age of 57 years old (51-62), 27 men and 16 women, with end-stage osteoarthritic ankle, in whom conservative treatment failed. We performed arthroscopic ankle arthrodesis with external joint distraction, after cruentation of the articular surfaces using a burr under direct visualization through two standard anterior portals and using a small joint arthroscope (2.7mm). The ankle fixation was performed using 3 cannulated percutaneous parallel screws through the medial tibial cortex into the talus, under fluoroscopic control.

The minimal follow-up was 18 months and the mean follow-up was 24 months.

We registered the pre and post-operative AOFAS hindfoot score. We observed that 40 patients (92,5%) had complete fusion between 12 and 16 weeks and showed marked improvements in the AOFAS hind foot score. 3 patients (7,5%) needed revision procedure by a classic open approach and bone grafting, with late (24-32 weeks) but successful outcome.

We conclude that the arthroscopic ankle arthrodesis is an effective procedure in dealing with end-stage osteoarthritic ankles, with high consolidation and low complication rates and showing high impact in the quality of life of the patients.