Open Ankle Arthrodesis Outcome: Comparison between Anterior and Lateral Approaches

Ankle arthrodesis is one of the major surgeries for the treatment of advanced osteoarthritis of the ankle joint. There are various techniques available for ankle arthrodesis and each technique has unique advantages and disadvantages. The aim of the present study was to evaluate the results of ankle arthrodesis with two this different approaches.

The medical records of the patients who were admitted for ankle arthrodesis and treated by a single surgeon from January 2015 to January 2020 were reviewed. The patients were recalled for re-evaluation after a mean follow-up of 19 months. Functional outcomes were assessed using validated AOFAS Ankle-Hind foot score, Manchester-Oxford Foot Questionnaire (MOXFQ) and visual analog scale (VAS) score for pain. The collected data were recorded in a pre-designed checklist and then analyzed using SPSS software.

A total of 32 patients, 18 men and 14 women with a mean age of 46.7 years were included in the study. 67.6% had history of ankle fractures. Anterior approach was used in 24 patients, 75%, and the rest of the patients had surgery with lateral approach (25%). The most common instrument for arthrodesis was concomitant use of plate and screws in 18 patients (56%). Union occurred in 28 patients (87.5%) within 11.1 weeks after the surgery. The AOFAS score increased significantly and MOXFQ and VAS scores decreased significantly following the surgery (p<0.001 for each). Advanced age and intramedullary nail were related to prolonged time to union (p<0.05). Surgical approaches (either anterior or lateral) had no association with AOFAS, MOXFQ, and VAS scores. Non-union was seen in 4 patients (12.5%) and deep infection in 3 patients (9.3%) after ankle arthrodesis.

The study results showed that, this surgery could improve patients’ pain and function with relatively low post-operative complications.