Open Ankle Arthrodesis

Abstract

Arthritis of the ankle can be disabling, often causing substantial impairment and disability. Prior trauma is the most common cause of ankle arthritis. Ankle arthritis may entail early degenerative changes or more involved and extensive “end-stage” disease. Nonsurgical treatments include activity modification, weight loss, anti-inflammatory medication, bracing, and injections. Ankle arthrodesis (fusion) is a commonly utilized treatment for end-stage ankle arthritis. The goal of an ankle fusion is to achieve a pain-free plantigrade extremity. Three open approaches frequently used to achieve an ankle arthrodesis are a trans-fibular technique, a fibular-sparing technique, and an open anterior technique. Patient-specific factors such as prior surgical scars and deformity may guide the approach utilized. To achieve a successful fusion, attention must be given to careful patient selection, perioperative counseling and care, gentle soft tissue handling, methodical joint preparation, accurate joint positioning, and rigid fixation. Most current studies of open ankle arthrodesis report a solid union with substantial pain relief in greater than 90% of patients.