Arthroscopic ankle arthrodesis: a preliminary report.
BACKGROUND
Over the past decade, arthroscopy has become a well-accepted technique for treating complex ankle problems. Recently, technical refinement with improvements in instrumentation has allowed more extensive arthroscopic debridement. With these improvements, arthroscopy can be used to perform successful arthrodesis of the ankle.


METHODS
Five arthroscopic ankle arthrodesis procedures were performed. Three patients had post-traumatic osteoarthritis, one had rheumatoid arthritis and one had gouty arthritis combined with pyogenic arthritis. Following arthroscopic resection of the synovial membrane, cartilage and subchondral bone from the tibial, fibular and talar articular surfaces, an autogenous iliac bone graft was performed using arthroscopic guidance. Two percutaneous screws were used for internal fixation in three cases. Postoperatively, patients wore a short leg walking cast for eight weeks. The average follow-up was 18.8 months (range, 12-24 months).


RESULTS
Clinical ankylosis was achieved in all cases and there was radiologic evidence of bone fusion in four cases. In one case, delayed union occurred, but it was achieved at the 12th postoperative month of follow-up.


CONCLUSIONS
Arthroscopic ankle arthrodesis is less invasive than open techniques and less painful after surgery; it also allows for a better cosmetic effect. There is a learning curve associated with arthroscopic ankle fusion, and it is time-consuming. Severe deformity is a contraindication for this method and such cases should only be treated using the open method.
Wang
D Y
DY
Department of Orthopedics, China Medical College Hospital, Taichung, Taiwan, ROC.
D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged