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PubMed · 16331381

[Ankle arthrodesis using the arthroscopic technique].

Pascal Rippstein·Bharat Kumar·Markus Müller
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Abstract

OBJECTIVE: Fast, safe and reliable ankle fusion through minimally invasive technique. INDICATIONS: Painful ankle arthritis unresponsive to conservative treatment. CONTRAINDICATIONS: Severe axial malalignment of ankle. Significant anteroposterior talar translation. Extensive bone defect. SURGICAL TECHNIQUE: Standard anteromedial and anterolateral arthroscopic portals. Excision of all anterior hypertrophic synovium using a soft-tissue shaver. Removal of anterior osteophytes with a motorized arthroscopic abrader (burr) to get better access to the joint. Removal of the remaining ankle cartilage using a sharp curette. Superficial opening of the subchondral bone with a motorized burr and deeper opening with an osteotome. Without arthroscopy but under image intensification, ankle fixation in neutral position by inserting two (or three) 6.5-mm cancellous lag screws from the tibia (medial and lateral) into the talus. POSTOPERATIVE MANAGEMENT: Partial weight bearing (15 kg) with a removable boot for 6 weeks. Then, first radiologic follow-up and in the presence of evidence of consolidation, full weight bearing with the boot for additional 2-4 weeks. RESULTS: Between September 1998 and February 2003, 28 arthroscopic ankle arthrodeses were performed. 23 ankles (82%) showed definite radiologic evidence of consolidation at 6 weeks postoperatively; patients were allowed to bear full weight without any consequences. All patients except two (93%) showed complete ankle fusion at their last radiologic follow-up at 1 year. Both patients with absent fusion were smokers; one of them was asymptomatic (stable fibrous union) and the other's ankle finally fused after surgical revision with open technique and bone grafting.

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AdultAgedAnkle JointArthralgiaArthrodesisArthroscopyBone ScrewsFemaleHumansJoint InstabilityMaleMiddle AgedOsteitisOsteoarthritisRadiographyRecovery of FunctionTalusTibiaTreatment OutcomeClinical TrialJournal Article

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BibTeXRIS

Pascal Rippstein, Bharat Kumar, Markus Müller. 2005. [Ankle arthrodesis using the arthroscopic technique].. https://doi.org/10.1007/s00064-005-1138-6

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