Clinical outcomes comparing arthroscopic vs open ankle arthrodesis

Woo, Bo Jun; Lai, Mun Chun; Ng, Sean Yc; Rikhraj, Inderjeet Singh; Koo, Kevin

doi:10.1016/j.fas.2019.06.004

Cited by 35 publications

(31 citation statements)

References 29 publications

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“…Woo et al conclude that the arthroscopic group displayed better clinical outcomes compared to the open group at the 24months follow-up. The advantages of arthroscopic ankle arthrodesis include significantly less perioperative pain, higher AOFAS Ankle-hindfoot scores at 24months, shorter length of stay, fewer postoperative complications [23]. In our study, it was also found that the incidence of complications of arthroscopic joint fusion was lower, and the postoperative recovery was faster.…”

Section: Discussionsupporting

confidence: 70%

Outcome Comparison of Arthroscopic versus Mini-open Technique for Ankle Arthrodesis

Wang

et al. 2020

Preprint

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Background Ankle arthrodesis is considered to be the gold standard for the treatment of end-stage ankle diseases. At present, the commonly used methods of ankle arthrodesis include open ankle arthrodesis, arthroscopic ankle arthrodesis and mini-open ankle arthrodesis. The authors analyze and compare the clinical efficacy and related complications of arthroscopic ankle arthrodesis and mini-open ankle arthrodesis in the treatment of end-stage ankle disease. Methods From January 2007 to June 2018, 56 patents with end-stage ankle joint pathology were treated with arthroscopic ankle arthrodesis and mini-open ankle arthrodesis. There were 30 cases in arthroscopy group, including 19 males and 11 females with an average age of 49.6 years old (ranged, 32 to 71); while 26 cases in mini-open group, including 18 males and 8 females with an average age of 48.3 years old (ranged, 43 to 65). The operative time was calculated with use of computerized operative and anesthetic records. The pain visual analogue score (VAS), American Orthopedic Foot ༆ Ankle Society ankle and hind foot score (AOFAS), fusion rate, complications rate, length of hospital stay, operation time, and tourniquet time were compared between the two groups of patients. Results 51 patients were followed up for 15–35 months (mean, 22.5 ± 1.5) months. The bony fusion was achieved in all patients. The average time to fusion was 12.4 weeks (range, 10–16 weeks). The VAS score 3 days post-operation was (6.37 ± 0.69) points in the arthroscopy group and (7.61 ± 1.05) points in the mini-open group, there was significant difference between the two groups (P < 0.05). The VAS score and AOFAS score between the two groups pre- and post-operation have statistically significant differences (P < 0.05). At the last follow-up, VAS score was (1.55 ± 0.57) in the arthroscopy group and (1.43 ± 0.73) in the mini-open group, and there was no significant difference between the two groups (P > 0.05). The AOFAS score was (85.32 ± 2.96) points in the arthroscopy group and (86.72 ± 3.05) points in the mini-open group, and there was no significant difference between the two groups (P > 0.05). Arthroscopic ankle fusion was associated with a shorter tourniquet time and shorter length of hospital stay compared to mini-open ankle fusion (P < 0.05); however, there was no significant difference between two groups in terms of operation time (P > 0.05). Wounds healing was satisfying during the follow-up in the arthroscopy group. But the wounds healing was delayed in two patients of the small incision group. All patients were satisfied with the surgery. Conclusion Arthroscopic ankle arthrodesis and mini-open ankle arthrodesis have satisfactory curative effect and fusion rate. Arthroscopic assisted ankle arthrodesis has more advantages, including small incision, less injury, and low morbidity.

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Section: Discussionsupporting

confidence: 70%

Outcome Comparison of Arthroscopic versus Mini-open Technique for Ankle Arthrodesis

Wang

et al. 2020

Preprint

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“…Recently ankle arthrodesis by using ankle arthroscopy and percutaneous screw fixation is gaining popularity from the nature of minimal invasiveness. 1 – 3 , 14 In addition to that, ankle arthrodesis by using new types of internal fixation locking plates is also popular due to the behavior of the implant as an internal fixator. 15 – 18 In contrast, ankle arthrodesis with an external fixator tends to be avoided because the procedure is more complicated and patients are uncomfortable with the fixator for prolonged periods of time.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, reports on arthroscopic ankle arthrodesis are gaining popularity because of minimal invasiveness but the indication is limited. 1 – 3 Similarly, there are recent papers on ankle arthrodesis using an external fixator for complex cases due to the versatility of the technique. 4 – 12 …”

Section: Introductionmentioning

confidence: 99%

A New Classification for Ankle Arthrodesis When Using an External Fixator

Matsubara¹,

Watanabe²,

Takata³

et al. 2020

Strategies in Trauma and Limb Reconstruction

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Background We have classified ankle arthrodesis when using an external fixator into four types based on the deformity and defect. Each of the four types of technique have been evaluated retrospectively. Materials and methods Thirty-three lower limb segments in 30 patients (average age 49 years) were treated by ankle arthrodesis using an external fixator in our institution. We classified the pre-treatment problems into four types and adjusted the surgical treatment accordingly: type I—no bone defect, no or mild deformity; type II—no bone defect, severe deformity; type III—bone defect with the possibility to shorten acutely after resection of the pathological focus; and type IV—bone defect but without the ability to shorten acutely after resection of the pathological focus. Type I problems were treated with curettage of ankle cartilage and bone graft with external fixation. Type II problems were treated with mobilisation using an external fixation after performing a type I ankle arthrodesis. Type III problems were treated with ankle arthrodesis using acute shortening and distraction. Type IV problems were treated with ankle arthrodesis using bone transport. Results All patients had secure ankle fusion and were able to bear total weight in walking on completion of treatment. The mean external fixation period was 96 days in type I, 181 days in type II, 231 days with lengthening in type III and IV. The complications included re-fracture in three cases, deformity at the lengthening site in one, delayed union in one, and infection at fusion site in one. Conclusion We have strategized ankle arthrodesis procedures using an external fixator into four groups in order to align the surgical technique with the pre-treatment problem. Our classification can help decide the appropriate operative method when using an external fixator, especially for difficult cases. How to cite this article Matsubara H, Watanabe K, Takata M, et al. A New Classification for Ankle Arthrodesis When Using an External Fixator. Strategies Trauma Limb Reconstr 2019;14(3):148–154.

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“…• velocidade de caminhada mais rápida • amplitude de movimento articular aumentada no plano sagital do antepé, • movimento sagital aumentado do retropé • maior flexão plantar do tornozelo Para deformidades leves e moderadas, a via artroscópica ou "mini-open" são opções seguras, e para deformidades graves, as vias anterior e lateral transfibular são mais indicadas. 68 As taxas de consolidação para as técnicas descritas variam de 72 a 93%, porém as taxas de não união em fumantes chegam a 54%. 69 As complicações mais frequentes são as deiscências de ferida, infecção superficial e neuroma; sendo necessários procedimentos de revisão em 7 a 9% dos casos, independente da técnica utilizada.…”

Section: Realizar Os Procedimentos Adicionais Quando Necessáriosunclassified

Osteoartrite do tornozelo

Godoy‐Santos

Fonseca

Giordano

et al. 2020

Rev Bras Ortop (Sao Paulo)

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ResumoA osteoartrite (OA) é caracterizada por uma degradação crônica, progressiva e irreversível da superfície articular, associada a inflamação articular. A principal etiologia da OA do tornozelo é pós-traumática e sua prevalência é maior entre os jovens e obesos. Apesar dos avanços no tratamento das fraturas ao redor do tornozelo, o risco geral de desenvolver OA pós-traumática do tornozelo após 20 anos do trauma é de quase 40%; especialmente nas fraturas bimaleolares de Weber tipo B e C e fraturas envolvendo a borda tibial posterior. Nas fraturas do tálus, essa prevalência se aproxima de 100%, dependendo da gravidade da lesão e do tempo de seguimento. Nesse cenário, é fundamental a compreensão atual das vias de sinalização moleculares envolvidas na senescência e apoptose dos condrócitos. O tratamento da OA do tornozelo é estagiado e guiado pelos sistemas de classificação, condições locais e do paciente. Os principais problemas são a limitada capacidade de regeneração da cartilagem articular, o baixo suprimento de sangue e a escassez de células-tronco progenitoras.A presente atualização resume evidências científicas básicas recentes da OA pós-traumática do tornozelo, com foco principal nas alterações metabólicas da sinóvia, da cartilagem e do líquido sinovial. Epidemiologia, fisiopatologia, implicações clínicas, e opções de tratamento são também discutidas.

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Clinical outcomes comparing arthroscopic vs open ankle arthrodesis

Cited by 35 publications

References 29 publications

Outcome Comparison of Arthroscopic versus Mini-open Technique for Ankle Arthrodesis

Outcome Comparison of Arthroscopic versus Mini-open Technique for Ankle Arthrodesis

A New Classification for Ankle Arthrodesis When Using an External Fixator

Osteoartrite do tornozelo

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