SLR - June 2013 - Jason E. Smith
Reference: Townshend D, Silvestro MD, Krause F, Penner M, Younger A, Glazebrook M, Kelikian A. Arthroscopic Versus Open Ankle Arthrodesis: A Multicenter Comparative Case Series, J Bone Joint Surg Am, 2013 Jan 16;95(2):98-102.
Scientific Literature Review
Reviewed by: Jason E. Smith, DPM
Residency Program: North Colorado Medical Center Podiatric Medicine and Surgery Residency
Podiatric Relevance: Ankle arthrodesis can be an indicated and effective procedure for ankle osteoarthritis. When the decision arises for a procedure such as an ankle arthrodesis, all avenues should be explored for best patient outcome and surgical results. In the podiatric realm, we are given a unique opportunity to provide relief and improvement in quality of life for a patient who suffers from osteoarthritis of the ankle joint. Possessing the knowledge and skills to select the best procedure will aid in greater overall patient care and lessen possible costs and recovery time.
Methods: This is a multicenter comparative case series where the authors evaluated the results of open and arthroscopic ankle arthrodesis procedures. The study included patients who were managed at two institutions and followed for two years. Outcomes include the use of an Ankle Osteoarthritis Scale score, and secondary outcomes using a Short Form-36 physical and mental component scores. This encompassed the length of hospital stay and radiographic alignment. There were thirty patients in each group.
Results: An Ankle Osteoarthritis Scale score and the Short Form-36 physical component score that were used in the study showed significant improvement at one and two years following the procedure. However; with the arthroscopic arthrodesis group there was significantly greater improvement in the Ankle Osteoarthritis Scale score at one year and two years and shorter hospital stay in. Surprisingly, in regards to complications, surgical time, and radiographic alignment, both groups were similar in outcomes.
Conclusions: The use of both the open and arthroscopic ankle arthrodesis procedures demonstrated significant improvement of pain and function. This was measured with an Ankle Osteoarthritis Scale score. The remarkable aspect of the study was that arthroscopic arthrodesis resulted in a shorter hospital stay and displayed better outcomes at one and two years. Armed with this knowledge a surgically skilled podiatrist could decrease costs, and hasten the recovery time of their patient who would warrant such a procedure.