Comparative study of outcome measures of arthroscopic versus mini arthrotomy ankle fusion: Is there any difference?

Abstract

Background: Ankle fusion is the benchmark procedure in refractory cases of ankle arthritis. In patients with good bone stock and minimal deformity, minimally invasive ankle fusion has been adopted. Aim: The aim of this work was to compare different outcome measures of arthroscopically assisted ankle fusion and mini-arthrotomy ankle fusions. Methods: This prospective study included 30 patients with post-traumatic ankle OA, who were treated by ankle fusion. Patients were divided regarding the adopted procedure into two groups, 15 patients in each group. Group A was treated using arthroscopic assisted ankle fusion and Group B using single incision mini arthrotomy ankle fusion. They were evaluated clinically with AFOAS, visual analogue scale of pain pre and post operatively, time of union, complications and satisfaction. Results: The results were satisfactory in 12 patients in group A and 11 patients in group B. While three patients (20%) in group A and four patients (26.6%) in group B had unsatisfactory results according to AFOAS and VAS. Sound solid ankle fusion was achieved in 13 (86.6%) ankles in group A with a mean fusion time of 14.4 weeks (range from 12-18 weeks) and 11 (73.3%) ankles in group B with a mean fusion time of 14.5 weeks. Two ankles in group A (13.3%) and four ankles in group B (26.6%) had non-union. The mean post-operative AOFAS was good in both groups 79.0 ± 9.2 in group A and 77.5 ± 10.1 in group B. Conclusion: No difference was found between single-incision mini- arthrotomy and arthroscopic assisted ankle fusion. Minimally invasive ankle arthrodesis (particularly arthroscopic assisted technique) offers a good option for the minimally deformed arthritic ankle.

Keywords: Ankle, arthritis, minimal invasive fusion