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Arthroscopic ankle arthrodesis for end-stage post-traumatic ankle arthritis

Objective To investigate effect of arthroscopic ankle arthrodesis in the treatment of endstage post-traumatic ankle arthritis.Methods Between July 2007 and December 2010,21 patients with post-traumatic ankle arthritis underwent arthroscopic arthrodesis in our hospital.There were 14 males and 7 females,aged from 21 to 68 years (average,37 years).Before operation,conservative treatments were unsuccessful in all patients.During operation,the articular cartilage was removed completely,and then micro-fracture was made in bone near articular surface.Then,the operating ankle were reduced and fixed provisionally with Kirschner wires.A C-arm X-ray system was used to confirm the reduction of operating ankle,and the operating ankle was fixed with cannulate screws if the reduction was satisfactory.Two patients also underwent arthroscopic subtalar arthrodesis.After operation,the affected ankle was fixed with plaster for six weeks.Then partial weight-bearing were allowed and gradually increased until bone union.Results All patients were followed up for 1 to 4 years (average,1.8 years).All affected ankle achieved bone union after 10 to 16 weeks (average,12 weeks).No early complications occurred,such as poor wound healing and infection.Subtalar arthritis with pain occurred in 3 patients; the symptom relieved in 2 of them after conservative treatment and in 1 patient after subtalar arthrodesis.The VAS score improved from preoperative 8.1±1.5 to 2.7± 1.1 one year postoperatively,which showed statistical significance (t=3.153,P=0.005).Conclusion Arthroscopic ankle arthrodesis provides an alternative method for treating end-stage post-traumatic ankle arthritis,which has some advantages,such as less surgical trauma,more beautiful incision and higher fusion rate.However,it needs special equipments and a learning curve. 
 
Key words: 
Ankle;  Arthritis;  Arthrodesis;  Arthroscopy