Annette Eidmann, Katharina Kraftborn, Matthias G Walcher, Lukas Fraißler, Maximilian Rudert, Ioannis Stratos
{"title":"[Arthroscopically assisted arthrodesis of the upper ankle joint].","authors":"Annette Eidmann, Katharina Kraftborn, Matthias G Walcher, Lukas Fraißler, Maximilian Rudert, Ioannis Stratos","doi":"10.1007/s00064-025-00899-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To obtain a pain-free, fully weight-bearing ankle joint in a functional position through minimally invasive arthrodesis.</p><p><strong>Indications: </strong>Symptomatic osteoarthritis of the upper ankle joint, which is no longer treatable conservatively or by joint-preserving surgical procedures.</p><p><strong>Contraindications: </strong>Revision arthrodesis, infections in the surgical area, circulatory disorders; extensive malalignment, large bony defects (relative contraindications).</p><p><strong>Surgical technique: </strong>Anteromedial and anterolateral standard portal to the upper ankle joint. Soft tissue debridement and, if necessary, removal of large ventral osteophytes and free joint bodies. Removal of the remaining tibiotalar articular cartilage using curettes, sharp spoons, chisels, or reamers. Opening of the subchondral bone with bone awls or chisels to expose the former joint surfaces. Anatomical adjustment of the joint, transfixation with 2 to 3 Kirschner wires for percutaneous stabilization with cannulated double-threaded screws or cancellous bone screws with short threads under X‑ray control.</p><p><strong>Postoperative management: </strong>Postoperative immobilization in an orthosis or plaster cast with unloading for 6 weeks; after X‑ray control, gradual increase in weight-bearing over a further 2-6 weeks.</p><p><strong>Results: </strong>In all, 30 arthroscopically assisted arthrodeses of the ankle joint performed between 2014 and 2017 were retrospectively evaluated. Of these, 22 patients were very satisfied, 5 patients were satisfied, and only 2 patients were not satisfied with the surgical outcome. The evaluation using postoperative scores (American Orthopaedic Foot and Ankle Society Score [AOFAS], Foot and Ankle Outcome Score [FAOS], Visual Analogue Scale Foot and Ankle [VAS-FA]) also yielded good results on average. The complication rates were comparable to those in the literature, with 2 pseudarthroses, 3 superficial wound healing disorders, and 2 irritations caused by the osteosynthesis material.</p>","PeriodicalId":54677,"journal":{"name":"Operative Orthopadie Und Traumatologie","volume":" ","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Operative Orthopadie Und Traumatologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00064-025-00899-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To obtain a pain-free, fully weight-bearing ankle joint in a functional position through minimally invasive arthrodesis.
Indications: Symptomatic osteoarthritis of the upper ankle joint, which is no longer treatable conservatively or by joint-preserving surgical procedures.
Contraindications: Revision arthrodesis, infections in the surgical area, circulatory disorders; extensive malalignment, large bony defects (relative contraindications).
Surgical technique: Anteromedial and anterolateral standard portal to the upper ankle joint. Soft tissue debridement and, if necessary, removal of large ventral osteophytes and free joint bodies. Removal of the remaining tibiotalar articular cartilage using curettes, sharp spoons, chisels, or reamers. Opening of the subchondral bone with bone awls or chisels to expose the former joint surfaces. Anatomical adjustment of the joint, transfixation with 2 to 3 Kirschner wires for percutaneous stabilization with cannulated double-threaded screws or cancellous bone screws with short threads under X‑ray control.
Postoperative management: Postoperative immobilization in an orthosis or plaster cast with unloading for 6 weeks; after X‑ray control, gradual increase in weight-bearing over a further 2-6 weeks.
Results: In all, 30 arthroscopically assisted arthrodeses of the ankle joint performed between 2014 and 2017 were retrospectively evaluated. Of these, 22 patients were very satisfied, 5 patients were satisfied, and only 2 patients were not satisfied with the surgical outcome. The evaluation using postoperative scores (American Orthopaedic Foot and Ankle Society Score [AOFAS], Foot and Ankle Outcome Score [FAOS], Visual Analogue Scale Foot and Ankle [VAS-FA]) also yielded good results on average. The complication rates were comparable to those in the literature, with 2 pseudarthroses, 3 superficial wound healing disorders, and 2 irritations caused by the osteosynthesis material.
期刊介绍：
Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care.
The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems.
Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.
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