Ankle arthritis: Tibiotalar arthrodesis
Arthritis of the ankle is a debilitating condition with multiple etiologies and is frequently associated with complex deformity and alterations in bone quality and architecture. Despite recent advancements in total ankle arthroplasty, ankle arthrodesis (AA) remains the historic mainstay of treatment for end-stage ankle arthritis refractory to conservative treatment. A multitude of options exist to achieve solid fusion, however, the guiding principles in each case include minimal soft tissue disruption, thorough preparation of the articular surfaces, and rigid fixation. Compensatory motion in the remaining hindfoot and midfoot joints leads to satisfactory patient gait, function, and return to activity following successful AA. Despite generally high union rates, however, there is a risk of major complications including nonunion and malunion, infection, and wound complications which may require revision surgery. Future efforts may aim to identify risk factors for nonunion, as well as aim to improve techniques for deformity correction, rigid stabilization, and management of complications following failed ankle arthrodesis.
