Abstract
Purpose: We reviewed retrospectively 27 ankle arthrodesis procedures performed from 1990 to 2001 to assess the mid-term outcome. These patients had had on average 1.5 ankle interventions before the arthrodesis. Mean follow-up was seven years.
Material and methods: The arthrodeses were performed for posttraumatic degeneration (n=21), sequelae of septic arthritis (n=3), poliomyelitis (n=2), and rheumatoid arthritis (n=1). Forty-four percent of the patients had osteoarthritis of the subtalar joint. The transfibular approach was used for 21 patients and an external fixation for five. One woman was treated with a 90 LC-DCP 4.5 plate.
Results: Union was achieved in 13 weeks. There were three cases of wound necrosis (11%), two cases of superficial infection 7%) and one case each of axonotomesis of the posterior tibial nerve (3%) and malunion (3%) which required revision for insertion of a transplantar screw. Using the AOFAS system, the mean function score at last follow-up 88.4/92 compared with 42/92. Eighty-eight percent of the patients were satisfied. At last follow-up, 75% of patients had signs of active subtalar osteoarthritis. Three patients were symptomatic.
Conclusion: Ankle arthrodesis is a good indication for symptomatic osteoarthritis of the ankle joint despite that it in the long-term it accelerates the development of degenerative disease in the subjacent articulations.
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