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

Abstract

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.