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Arthroscopic ankle arthrodesis vs arthroscopic tibio-talo-calcaneal fusion: Outcomes and patient satisfaction
ESSKA Academy. Polyzos A. Nov 8, 2019; 284349; epAFAS-10 Topic: Arthroscopic Surgery
Mr. Apostolos Polyzos
Mr. Apostolos Polyzos
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Arthroscopic ankle arthrodesis vs arthroscopic tibio-talo-calcaneal fusion: Outcomes and patient satisfaction

ePoster - epAFAS-10

Topic: Hindfoot Arthritis

Polyzos A., Gkoumousian K., Petrakis I., Eleftheropoulos A.
General Hospital of Naousa, Orthopaedic Surgery Department, Naousa, Greece

Introduction: It is supported that patients undergoing arthroscopic tibio-talo-calcaneal(TTC) fusion have worse outcomes and lower satisfaction scores than those after arthroscopic ankle arthrodesis(AA).
Οbjectives: To present our results after comparing outcomes and patient satisfaction in both techniques.
Aims: To demonstrate that TTC fusion even performed arthroscopically should be chosen as a salvage procedure in severe cases of hindfoot arthritis and not for treating ankle pathology.
Methods: Between 2012 and May 2018, 15 patients (5 male and 10 female) with a mean age of 68 years who underwent arthroscopic TTC fusion and 17 patients (8 male and 9 female) with a mean age of 62 years who underwent arthroscopic AA were retrospectively analysed concerning their outcomes and their satisfaction score(American Orthopaedic Foot & Ankle Society (AOFAS) and SF-12 ).
TTC fusion was performed in a prone position using posterior hindfoot endoscopy. After the preparation of the ankle joint, an intramedullary retrograde nail was introduced and fixed in a locking position.Afterwards, the subtalar joint was prepared.
AA was performed in the supine position using a standard anterior ankle arthroscopy technique.Subsequently, after preparing the ankle joint surfaces two 6.5 or 7.0 mm cannulated screws were used to fuse the ankle joint.The minimum follow-up time was 12 months.
Results: Fusion was achieved in all TTC fusion and AA patients. There were no significant complications such as infection, non-union, mal-union, hardware failure or any trauma complications. In 4 patients in the TTC fusion group, the hardware was removed after 24 months due to plantar pain.Fusion was achieved in about three months in all patients.The postoperative AOFAS score was was significantly improved in both fusion techniques.The mean AOFAS score for the TTC fusion group was 68/100 while the mean AOFAS score for the AA group was 81/100.Patients in the TTC group had a mean SF-12(Physical) score 34,9 and SF-12(Mental) of 60. The mean SF-12(Physical) score was 49,1 and mean SF-12(Mental) score was 57,1 in patients who underwent AA.Patients in the ankle fusion group returned to their daily activities after three months.On the contrary, patients who underwent TTC fusion returned to their daily activities after 4 to 5 months.
Conclusions: TTC fusion nevertheless performed with a minimally invasive technique has worse results than AA and should be delivered in severe cases of hindfoot arthritis.
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