Arthroscopic Ankle Arthrodesis: A Review of Current Concepts and Technique

Background: Open ankle arthrodesis (OAA) has traditionally been the gold standard for improving pain and function in ankle osteoarthritis patients. With advances in arthroscopic technology and improved instrumentation, arthroscopic ankle arthrodesis (AAA) has become more popular among orthopedic surgeons with equivalent or better outcomes compared with OAA. Recent studies have shown that, with increasing experience, AAA can even be suitable for large deformities, which has been traditional viewed as a relative contraindication. A review of literature and concepts with expert opinion. AAA has been shown in the literature to have equivalent fusion rates, decreased hospital length of stay, and better short-term and long-term function when compared with OAA. Arthroscopy advantages include faster time to union, decreased morbidity, decreased blood loss, and accelerated rehabilitation. Advanced arthroscopic techniques and instrumentation facilitate joint preparation with limited soft tissue injury, creating a favorable environment for fusion. Arthroscopic techniques lead to better short-term and long-term outcomes and decreased complications compared with open arthrodesis. The technique has been shown to be successful and reproducible within the literature, and can be employed to ultimately reduce overall hospital care costs and improve patient outcomes. Level of Evidence: Diagnostic Level V. See Instructions for Authors for a complete description of levels of evidence.