Our Summary

This research paper looks at the best surgical treatments for severe ankle arthritis. It compares open ankle fusion surgery, which has been proven effective over time, with newer techniques using an arthroscope (a small camera that helps doctors see inside a joint). The paper also discusses the results of these procedures versus total ankle replacement. The authors detail the method of performing ankle fusion surgery using an arthroscope, even for patients with significant deformities inside the joint. The paper implies that this arthroscopic technique might be a beneficial and feasible option for treating end-stage ankle arthritis.

FAQs

  1. What is the surgical technique of arthroscopic ankle arthrodesis?
  2. How does the outcome of arthroscopic ankle arthrodesis compare with open ankle fusion and total ankle replacement?
  3. Who typically suffers from end-stage ankle arthritis and how does it affect the choice of surgical treatment?

Doctor’s Tip

One helpful tip a doctor might tell a patient about joint fusion is to follow post-operative rehabilitation protocols and physical therapy recommendations closely to ensure proper healing and optimal function of the fused joint. It is important to adhere to these guidelines to achieve the best possible outcome and regain strength and mobility in the affected joint.

Suitable For

Patients with end-stage ankle arthritis who have not responded to conservative treatment options such as medication, physical therapy, and bracing are typically recommended for joint fusion. This includes individuals who experience severe pain, stiffness, swelling, and limited range of motion in the ankle joint.

Patients who have sustained a severe ankle injury or have a history of ankle instability may also benefit from joint fusion to stabilize the joint and reduce the risk of further damage. Additionally, patients with conditions such as rheumatoid arthritis, osteoarthritis, or post-traumatic arthritis may be candidates for ankle fusion to improve their quality of life and function.

Overall, joint fusion is recommended for patients who have failed other treatment options and continue to experience significant pain and disability due to end-stage ankle arthritis. It is important for patients to discuss their individual case with a healthcare provider to determine the most appropriate treatment plan for their specific needs.

Timeline

Before joint fusion:

  • Patient experiences chronic pain, swelling, and stiffness in the affected joint
  • Patient may have tried conservative treatments such as physical therapy, medications, and injections without success
  • X-rays and other imaging tests are performed to assess the severity of arthritis and joint damage
  • Patient and surgeon discuss surgical options, including open ankle arthrodesis or arthroscopic ankle arthrodesis
  • Surgery is scheduled and pre-operative evaluations and preparations are completed

After joint fusion:

  • Patient undergoes arthroscopic ankle arthrodesis surgery, where the surgeon uses a camera and small instruments to remove damaged cartilage and fuse the joint
  • Patient is typically able to bear weight on the operated leg immediately after surgery and may need to use crutches or a walking boot for support
  • Physical therapy is initiated to help improve strength, flexibility, and range of motion in the ankle
  • Follow-up appointments with the surgeon are scheduled to monitor healing and address any concerns
  • Over time, the fused joint becomes stable and pain-free, allowing the patient to return to activities with reduced pain and improved function.

What to Ask Your Doctor

  1. What is the success rate of arthroscopic ankle arthrodesis compared to open ankle fusion and total ankle replacement for my specific condition?
  2. What are the potential risks and complications associated with arthroscopic ankle arthrodesis?
  3. How long is the recovery period after arthroscopic ankle arthrodesis surgery?
  4. Will I be able to return to my normal level of physical activity after undergoing arthroscopic ankle arthrodesis?
  5. Are there any alternative treatments or procedures that I should consider before proceeding with ankle fusion surgery?
  6. How long can I expect the fusion to last before needing additional surgery?
  7. Will I need physical therapy after the surgery, and if so, for how long?
  8. What type of anesthesia will be used during the arthroscopic ankle arthrodesis procedure?
  9. How many of these procedures have you performed, and what is your success rate?
  10. What can I do to optimize my chances of a successful outcome after arthroscopic ankle arthrodesis surgery?

Reference

Authors: Leucht AK, Veljkovic A. Journal: Foot Ankle Clin. 2022 Mar;27(1):175-197. doi: 10.1016/j.fcl.2021.11.008. Epub 2022 Jan 3. PMID: 35219365