Study finds similar outcomes between arthroscopic, open ankle arthrodesis at 5 years
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CHARLOTTE, N.C. — According to a presenter, arthroscopic ankle arthrodesis and open ankle arthrodesis yield similar patient-reported outcome measures despite some variance in survivorship and complications.
“We dug a bit further into ankle arthrodesis in general and who are the patients that would benefit better from open vs. arthroscopic ankle fusion,” Oliver Gagné, MD, said in his presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
In their retrospective longitudinal cohort study, Gagné and colleagues analyzed data from 223 arthroscopic ankle arthrodesis (AAA) procedures and 128 open ankle arthrodesis (OAA) procedures performed between 2003 and 2019. Patient-reported outcome measures (PROMs), major complication rates, survivorship of the arthrodesis, ankle arthritis score (AAS), ankle osteoarthritis score (AOS), SF-36 scores, expectation, satisfaction and swelling scores were collected annually from 6 months to 5 years after surgery.
Preoperatively, Canadian Orthopedic Foot and Ankle Society (COFAS) type was higher in the OAA group and AAS and AOS scores were better in the AAA group, Gagné noted.
Overall, the AAA group had higher mean AAS scores at 1-year postoperatively; however, there were no other differences in PROMs at any other timepoint, according to the abstract. The AAA group also demonstrated lower survivorship of the arthrodesis, which was due to the higher rate of amputation or fusion, Gagné said. Deep infection and wound complications were more prevalent in the OAA group.
“Revisions were higher in the AAA group, and revisions secondary to infection were higher in the OAA group,” Gagné added. “So, the question really is about patient selection and who do you indicate for what surgery. Should you do arthroscopic fusion in people who have a higher risk of infection?”
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Abuhantash M, et al. Arthroscopic vs open ankle arthrodesis: A 5-year comparison. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting. Sept. 22 - Sept. 25, 2021; Charlotte, N.C.
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