Skip to main content
SpringerLink
Log in

Minimally Invasive Ankle Arthrodesis

  • Chapter
  • First Online:
Minimally Invasive Surgery in Orthopedics

Abstract

The ankle joint is a constrained mortise and tenon-type joint consisting of the distal tibial plafond and fibula articulating with the dome of the talus. Arthritis of the ankle can result in pain, joint incongruence, decreased motion, and functional disability. The most common etiology of ankle arthritis is posttraumatic, which includes cartilaginous injury and ligamentous insufficiency.1 Other less common causes of arthritis include the inflammatory arthritides, osteonecrosis, infection, and Charcot neuroarthropathy.2

To date, the ankle remains one of the few major extremity joints in which arthrodesis is the gold standard surgical treatment for advanced arthritis that has failed nonoperative management. Open ankle arthrodesis was first described by Albert in 1879.3 Fusion through an open arthrotomy has received numerous modifications since that time, but remains a widely used technique for surgical exposure. Currently, the most common surgical exposure for open ankle arthrodesis is the lateral transfibular approach. Upon osteotomy, the distal fibula can be used either as bone graft or as a lateral strut to increase the stability of the arthrodesis construct. Preparations of the distal tibia and talar dome through these open techniques include either “dome” cuts or flat cuts. Dome cuts allow for minimal loss of height, but do not offer much in terms of angular correction. Straight, flat cuts allow for correction of significant deformity, but can result in loss of joint height.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 349.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Raikin S. Arthrodesis of the ankle: arthroscopic, mini-open, and open techniques. Foot Ankle Clin North Am 8: 347–359, 2003

    Article  Google Scholar 

  2. Coughlin M. Arthritides. In: Coughlin M (ed.) Surgery of the foot and ankle. St. Louis: Mosby; pp. 560–650, 1999

    Google Scholar 

  3. Albert E. Beitrage zur operativen chiurgie. Zur resection des kniegelenkes. Wien Med Press 20: 705–708, 1879

    Google Scholar 

  4. Greisberg J, Assal M, Flueckiger G, Hansen, ST. Takedown of ankle fusion and conversion to total ankle replacement. Clin Orthop Relat Res 424: 80–88, 2004

    Article  PubMed  Google Scholar 

  5. Schneider D. Arthroscopic ankle fusion. Arth Video J 3, 1983

    Google Scholar 

  6. Morgan C. Arthroscopic tibio-talar arthrodesis. Jefferson Orthop J 16: 50–52, 1987

    Google Scholar 

  7. Myerson M, Allon S. Arthroscopic ankle arthrodesis. Contemp Orthop 19: 21–27, 1989

    Google Scholar 

  8. Ogilvie-Harris D, Lieberman I, Fitsialos D. Arthroscopically assisted arthrodesis for osteoarthrotic ankles. J Bone Joint Surg 75A: 1167–1173, 1993

    Google Scholar 

  9. Zvijac J, Lemak L, Schurhoff M, Hechtman K, Uribe J. Analysis of arthroscopically assisted ankle arthrodesis. Arthroscopy 18(1): 70–75, 2002

    Article  PubMed  Google Scholar 

  10. Myerson M, Quill G. Ankle arthrodesis: a comparison of an arthroscopic and an open method of treatment. Clin Orthop Relat Res 268: 84–95, 1991

    PubMed  Google Scholar 

  11. Winson IG, Robinson DE, Allen PE. Arthroscopic ankle arthrodesis. J Bone Joint Surg Br 87(3): 343–347, 2005

    Article  CAS  PubMed  Google Scholar 

  12. Paremain G, Miller S, Myerson M. Ankle arthrodesis: results after the miniarthrotomy technique. Foot Ankle Int 17(5): 247–252, 1996

    CAS  PubMed  Google Scholar 

  13. Demetriades L, Strauss E, Gallina J. Osteoarthritis of the ankle. Clin Orthop Relat Res 349: 48–57, 1998

    Article  Google Scholar 

  14. Raikin SM, Brislin K. Local bone graft harvested from the distal tibia or calcaneus for surgery of the foot and ankle. Foot Ankle Int 26(6): 449–453, 2005

    PubMed  Google Scholar 

  15. Buck P, Morrey BF, Chao EY. The optimum position of arthrodesis of the ankle. A gait study of the knee and ankle. J Bone Joint Surg 69A: 1052–1062, 1987

    Google Scholar 

  16. Mann R, Van Manen J, Wapner K, et al. Ankle fusion. Clin Orthop Relat Res 268: 49–55, 1991

    PubMed  Google Scholar 

  17. King H, Watkins T Jr, Samuelson K. Analysis of foot position in ankle arthrodesis and its influence on gait. Foot Ankle 1: 44–49, 1980

    CAS  PubMed  Google Scholar 

  18. Wu W, Su F, Cheng Y, et al. Gait analysis after ankle arthrodesis. Gait Posture 11: 54–61, 2000

    Article  CAS  PubMed  Google Scholar 

  19. Dohm M, Benjamin J, Harrison J, et al. A biomechanical evaluation of three forms of internal fixation used in ankle arthrodesis. Foot Ankle Int 15: 297–300, 1994

    CAS  PubMed  Google Scholar 

  20. Ogilvie-Harris D, Fitsialos D, Hedman T. Arthrodesis of the ankle. A comparison of two versus three screw fixation in a crossed configuration. Clin Orthop Relat Res 304: 195–199, 1994

    PubMed  Google Scholar 

  21. Verkelst M, Mulier J, Hoogmartens M, et al. Arthrodesis of the ankle joint with complete removal of the distal part of the fibula: experience with the transfibular approach and three different types of fixation. Clin Orthop Relat Res 118: 93–99, 1976

    Google Scholar 

  22. Holt E, Hansen S, Mayo K, et al. Ankle arthrodesis using internal screw fixation. Clin Orthop Relat Res 268: 21–28, 1991

    PubMed  Google Scholar 

  23. Nasson S, Shuff C, Palmer D, et al. Biomechanical comparison of ankle arthrodesis techniques: crossed screws vs. blade plate. Foot Ankle Int 22: 575–580, 2001

    CAS  PubMed  Google Scholar 

  24. Miller SD, Paremain GP, Myerson MS. The miniarthrotomy technique of ankle arthrodesis: a cadaver study of operative vascular compromise and early clinical results. Orthopedics 1996 19(5): 425–430

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Orthopaedic Surgery, Rothman Institute and Thomas Jefferson University Hospital, 925 Chestnut Street, Philadelphia, PA, 19107, USA

    Jamal Ahmad & Steven M. Raikin

Authors
  1. Jamal Ahmad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Steven M. Raikin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven M. Raikin .

Editor information

Editors and Affiliations

  1. Insall Scott Kelly Institute, East 64th St. 210, New York, 10021, U.S.A.

    Giles R. Scuderi

  2. Orthopaedic Center of New Jersey, Route 27 1527, Somerset, 08873, U.S.A.

    Alfred J. Tria

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Ahmad, J., Raikin, S.M. (2010). Minimally Invasive Ankle Arthrodesis. In: Scuderi, G., Tria, A. (eds) Minimally Invasive Surgery in Orthopedics. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76608-9_45

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-76608-9_45

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-76607-2

  • Online ISBN: 978-0-387-76608-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation