Open Ankle Arthrodesis: A Retrospective Analysis Comparing Different Fixation Methods

Heuvel, Stein B.M. van den; Penning, Diederick; Schepers, Tim

doi:10.1053/j.jfas.2021.07.012

Cited by 11 publications

(6 citation statements)

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“…It has been stated that the choice of intramedullary nail or plate may be considered in this region where compression is targeted. In a recent study comparing these three techniques, 42 patients were retrospectively examined [14]. Although van den Heuvel et al did not encounter any complications (such as non-union and infection) in the patient group in which intramedullary nailing was applied, a significantly higher infection rate was observed in the plate fixation group.…”

Section: Discussionmentioning

confidence: 99%

Tibiotalocalcaneal Ankle Arthrodesis with Posterior Approach Arthroscopic-Assisted Hindfoot Nailing, Early-Mid-Term Clinical, and Radiological Results: A Retrospective Analysis of 25 Patients

Ertan,

Özbek,

Yoğun

et al. 2024

Preprint

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Background: End-stage ankle arthrosis causes severe pain and limited movement. In this case, tibiotalocalcaneal arthrodesis (TTCA) surgery forms the basis for surgical treatment in the appropriate patient group. TTCA with arthroscopy-assisted hindfoot nailing can be used to achieve a high union rate and low complication rate. In this study, we aimed to examine the early- and mid-term results of patients treated with this technique from various perspectives and to evaluate them by comparing them with the current literature. Methods: Data were collected from 25 patients who met the established criteria and underwent TTCA with posterior approach arthroscopic-assisted hindfoot nailing. In addition to the demographic data of the patients, their clinical and pain scores were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS). These scoring data were collected preoperative, postoperative 3rd month, postoperative 12th month, and at the final postoperative follow-up (18–24th months). Additionally, the union time and complication data during the follow-up period were examined. Results: When the AOFAS and VAS scores of the 25 patients were examined, a significant improvement was observed in the preoperative period and early postoperative period comparisons (p < 0.001). No significant change was observed between the comparison of the postoperative 12th month and last postoperative control clinical scores. While the union rate of the patients was observed to be 92%, the average union time was 13.1 ± 3.5 weeks. During follow-up, peri-implant fracture, deep infection, and non-union were observed in one patient each (12%). Conclusion: The early- and mid-term postoperative results of patients treated with TTCA surgery with posterior approach arthroscopic-assisted hindfoot nailing show that this technique may be an option with low complication and high union rates for the appropriate group of patients planned for ankle arthrodesis.

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Section: Discussionmentioning

confidence: 99%

Tibiotalocalcaneal Ankle Arthrodesis with Posterior Approach Arthroscopic-Assisted Hindfoot Nailing, Early-Mid-Term Clinical, and Radiological Results: A Retrospective Analysis of 25 Patients

Ertan,

Özbek,

Yoğun

et al. 2024

Preprint

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“…Артродез ГСС -надежный метод лечения поздних стадий ОА ГСС, который эффективно снижает интенсивность боли и улучшает функцию пораженной конечности [4]. Успешность артродеза ГСС лежит в соблюдении нескольких ключевых принципов, включая адекватный костный контакт, межкостную компрессию и стабильность в области костного контакта [8,13]. При этом показатель излечения составляет 85-100 % [9,15].…”

Section: Discussionunclassified

“…В традиционном понимании ВФ считается более предпочтительной методикой вследствие удобства ее применения и высокой частоты сращения [24]. Более поздние исследования показали благоприятные показатели сращения при ВФ -от 91 до 100 % [8]. Однако нет гарантии его пригодности для пациентов с остеопорозом [25].…”

Section: Discussionunclassified

“…К причинам вторичного остеоартроза голеностопного сустава (ГСС) относятся травма, ревматоидный артрит, остеонекроз таранной кости, неудачные хирургические вмешательства, анатомическая деформация и т.п. [6,7], причем посттравматический остеоартроз является наиболее частой причиной развития патологии, его доля составляет до 78 % [8,9].…”

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Evaluation of the effectiveness of ankle arthrodesis options

Wang,

Akhtiamov,

Cai

et al. 2024

jour

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Introduction Treatment methods for late stages of ankle osteoarthritis are varied, but the issue of assessing the long-term results of various fixation methods has not yet been studied, and this issue is of great importance in clinical practice.Purpose To compare the effectiveness of the fixation methods commonly used for ankle arthrodesis in patients with advanced ankle osteoarthritis.Materials and methods Eighty-two patients with advanced ankle osteoarthritis were treated with ankle fusion between 2019 and 2023 at three major medical institutions. All patients underwent 12-month follow-ups. The patients were divided into four groups depending on the method of surgical fixation of bone fragments.Results Most patients showed a significant improvement in the function and a decrease in pain intensity after the arthrodesis operation. The comparison of the effectiveness of various surgical fixation methods found that external apparatus screw fixation is characterized by lower blood loss and a relatively short duration of the operation. Plate and screw fixation resulted in higher AOFAS and VAS scores at 3 months postoperatively. However, by the 12th month after surgery, the differences in these two indicators were insignificant.Discussion Despite the various complications that occur in ankle arthrodesis, it remains effective for most patients. Among them, the Ilizarov apparatus is more suitable for patients with compromised conditions in the surgical area. Each method of surgical fixation has its own advantages and shortcomings, but the difference in long-term effectiveness is small. Conclusion Ankle arthrodesis is an effective treatment for advanced ankle osteoarthritis. The choice of surgical method is still subject to the principle of individual approach.

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“…Some recent literature has been produced focusing on AA performed using cannulated screws 8 , 13 – 15 , overall suggesting that using different number of screws or combining various thread designs or positioning metalwork in different configurations does not clearly affect the success rate of the procedure. At times, surgeons may decide to place some cancellous bone at the fusion site or to use an onlay fibular strut autograft placed laterally as a bridge between the tibia and the talus, with the aim to add both a biological and mechanical augmentation to the fixation 16 .…”

Section: Introductionmentioning

confidence: 99%

Role of fibular autograft in ankle arthrodesis fixed using cannulated screws: a proportional meta-analysis and systematic review

Bernasconi,

Izzo,

D’Agostino

et al. 2023

Sci Rep

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Ankle arthrodesis is commonly performed to treat end-stage ankle osteoarthritis. The aim of this study was to determine whether the use of fibular autograft might increase the fusion rate and decrease the complication rate in ankle arthrodesis (AA) fixed using cannulated screws. To perform this PRISMA-compliant proportional meta-analysis, multiple databases were searched for studies in which patients undergone AA (using exclusively cannulated screws and augmented with fibular bone graft) were followed. The characteristics of the cohort, the study design, surgical details, the nonunion and complication rate at the longest follow-up were extracted and recorded. The modified Coleman Methodology Score (mCMS) was applied to appraise the quality of studies. Two groups were built: arthrodeses fixed with screws combined with cancellous autograft (G1) and arthrodeses fixed with screws combined with cancellous autograft and augmented with a lateral fibular onlay (G2). A third group (arthrodeses fixed with screws and no graft, G3) was extracted from previous literature for a further comparison. Overall, we included 306 ankles (296 patients) from ten series (ten studies). In G1 and G2 there were 118 ankles (111 patients) and 188 ankles (185 patients), respectively. In patients where cancellous autograft was used, a further augmentation with a fibular lateral strut autograft did not change significantly the nonunion (4% [95% CI 1–9] in G1 vs. 2% [95% CI 0–5) in G2, p = 0.99) nor the complication rate (18% [95% CI 0–36] in G1 vs. 13% [95% CI 6–21) in G2, p = 0.71). Upon comparison with 667 ankles (659 patients, G3) in which arthrodeses had been performed without grafting, the nonunion and complication rates did not differ significantly either (pooled estimates: 3% [95% CI 1–3) in G1 + G2 vs. 3% [95% CI 2–4] in G3, p = 0.73 for nonunion; 15% [8–23] in G1 + G2 vs. 13% [95% CI 9–17] in G3, p = 0.93 for complications). In ankle arthrodesis fixed with cannulated screws combined with cancellous autograft at the fusion site, a construct augmentation with a distal fibular onlay strut graft positioned laterally at the ankle joint does not reduce the risk of nonunion or complication. In general, the use of bone graft does not influence significantly the nonunion nor the complication rate as compared to non-grafted screw-fixed ankle arthrodeses.Kindly check and confirm the corresponding author mail id is correctly identified.It's all correct

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Open Ankle Arthrodesis: A Retrospective Analysis Comparing Different Fixation Methods

Cited by 11 publications

References 54 publications

Tibiotalocalcaneal Ankle Arthrodesis with Posterior Approach Arthroscopic-Assisted Hindfoot Nailing, Early-Mid-Term Clinical, and Radiological Results: A Retrospective Analysis of 25 Patients

Tibiotalocalcaneal Ankle Arthrodesis with Posterior Approach Arthroscopic-Assisted Hindfoot Nailing, Early-Mid-Term Clinical, and Radiological Results: A Retrospective Analysis of 25 Patients

Evaluation of the effectiveness of ankle arthrodesis options

Role of fibular autograft in ankle arthrodesis fixed using cannulated screws: a proportional meta-analysis and systematic review

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