J Korean Foot Ankle Soc.  2014 Dec;18(4):183-188. 10.14193/jkfas.2014.18.4.183.

Early Weight Bearing Ambulation after Arthroscopic Ankle Arthrodesis

Affiliations
  • 1Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, School of Medicine, The Catholic Universtiy of Korea, Seoul, Korea. koreafoot@gmail.com
  • 2Department of Orthopedic Surgery, St. Vincent's Hospital, School of Medicine, The Catholic University of Korea, Suwon, Korea.

Abstract

PURPOSE
The accepted general management principle after ankle arthrodesis is to maintain non-weight bearing for 6 to 8 weeks. The aim of this study was to report clinical outcome of patients allowed early weight bearing after arthroscopic arthrodesis.
MATERIALS AND METHODS
We analyzed medical records and radiographs to determine fusion rate and complication risk of 22 sequential patients allowed to walk under short leg cast within 3 days after arthroscopic ankle arthrodesis using 2 screws from January 2008 to June 2012. The minimum follow-up period was 18 months, and the mean age of the patients was 67 years.
RESULTS
The mean visual analog scale was decreased from 8.9 points preoperatively to 2.3 points after 12 months. Complete ankle fusion was achieved in 19 patients (86.4%) at 3-month follow-up. There were 2 cases of delayed union and one case of nonunion at 12-month follow-up. There was no other complication such as wound problem, persistent swelling of the ankle.
CONCLUSION
Bony union may not be interfered even though patients were allowed to walk under cast within a few days after arthroscopic ankle arthrodesis.

Keyword

Ankle; Arthroscopy; Arthrodesis; Early weight bearing

MeSH Terms

Ankle*
Arthrodesis*
Arthroscopy
Follow-Up Studies
Humans
Leg
Medical Records
Visual Analog Scale
Walking*
Weight-Bearing*
Wounds and Injuries

Figure

  • Figure 1. The preoperative anteroposterior (A) and lateral (B) radiographs of 68-year-old male patient showed severe osteoarthritis of the left ankle. (C, D) This patient was allowed to bear weight in a short leg walking cast on postoperative day. (E, F) Postoperative radiographs at 3 months demonstrated solid fusion of the joint.

  • Figure 2. The preoperative (A) and immediate postoperative (B) lateral radiograph of 63-year-old female patient showed the gap was formed all over the joint after the surgery. (C) The postoperative radiograph at 16 weeks demonstrated incomplete fusion at the posterior joint.

  • Figure 3. The single case of nonunion in our study. The preoperative (A) and immediate postoperative (B) lateral radiograph of 71-year-old female patient showed large gap was formed at the anterior joint after screw fixation. (C) At six weeks the screw was migrated and the size of the anterior gap was decreased after weight bearing ambulation. (D) The postoperative radiograph at 12 months demonstrated fibrous nonunion of the joint after reinsertion of the screw.


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