Mini-open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver St
- PDF / 1,110,961 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 93 Downloads / 172 Views
ORIGINAL ARTICLE
Mini‑open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study Karthikeyan Chinnakkannu1 · Haley M. McKissack1 · Jun Kit He1 · Bradley Alexander1 · John Wilson1 · Gean C. Viner1 · Ashish Shah1 Received: 9 July 2020 / Accepted: 20 August 2020 © Indian Orthopaedics Association 2020
Abstract Background Arthrodesis is considered the gold standard for end-stage ankle arthritis in patients who fail conservative management. Achieving union is paramount while minimizing complications. An essential item for successful union is preparation of the articular surface. Our study aims to evaluate the difference in joint preparation between direct lateral and dual mini-open approaches. Materials and Methods Ten below knee fresh-frozen specimens were used for this study. Five were prepared through lateral approach, and five using dual mini-incisions. After preparation, all ankles were dissected and images of tibial plafond and talar articular surfaces were taken. Surface areas of articulating facets and unprepared cartilage of talus, distal tibia, and distal fibula were measured and analyzed. Results A greater amount of total surface area was prepared with the mini-open approach in comparison to the transfibular approach. Percentage of prepared surface area of total articulating surface (including talus and tibia/fibula), talus, tibia, and fibula with the transfibular approach were 76.9%, 77.7%, and 75%, respectively. Percentages were 90.9%, 92.9%, and 88.6% with the mini-open approach. When excluding medial gutter, there was no significant difference between techniques (83.94% vs. 90.85%, p = 0.1412). Conclusion Joint preparation with the mini-open approach is equally efficacious as the transfibular approach for the tibiotalar joint. The mini-open approach does provide superior preparation of the medial gutter and inferior tibial surface which may help to increase union rates and decreased complications. Level of Evidence V. Keywords Ankle arthrodesis · Transfibular approach · Mini-open approach · Joint preparation · Nonunion · Ankle arthritis * Ashish Shah [email protected] Karthikeyan Chinnakkannu [email protected] Haley M. McKissack [email protected] Jun Kit He [email protected] Bradley Alexander [email protected] John Wilson [email protected] Gean C. Viner [email protected] 1
Department of Orthopaedic Surgery, University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL 35205, USA
Introduction Ankle arthrodesis is a common procedure that can be indicated for symptoms such as pain, instability, or deformity. These issues commonly arise from conditions including but not limited to malunion, nonunion, arthritic pain, failed total ankle arthroplasty, posttraumatic injury, osteoarthritis, rheumatoid arthritis, congenital anomalies, and neurotraumatic injury [1–4]. Outcomes are dependent upon successful union, which may be impacted by a multitude of patientrelated factors including comorbidities, smoking status
Data Loading...
