Ankle Arthrodesis.pptx

Ankle Arthrodesis.pptx

• 1.
  Ankle Arthrodesis Dr. Mirza ZeeshanSikandar HO Orthopedics
• 2.
  Arthrodesis  Arthrodesis refersto the fusion of two or more bones in a joint.  The diseased cartilage is removed, the bone ends are cut off, and the two bone ends are fused into one solid bone with metal internal fixation.  Arthrodesis result in relief of pain but at the same time salvage of associated joint; resulting in restricted/ no movements at that joint.
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  Indications of Arthrodesis Painful arthritis I. infection II. trauma (most common cause) III. chronic instability IV. AVN of the talus V. inflammatory arthropathy VI. primary OA
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  neuropathic arthropathy tumor resection salvagefor failed ORIF salvage for failed TAA
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  Ankle Arthrodesis  Anklearthrodesis is the fusion of the tibiotalar joint most commonly performed for end-stage arthritis of the joint.
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  Types of AnkleArthrodesis  Subtalar arthrodesis  Pantalar arthrodesis  Triple Arthrodesis
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  Subtalar arthrodesis  Thesubtalar joint is a complex joint located below the ankle joint and is formed by the union of the heel (calcaneus) and the talus (ankle) bone.  The subtalar joint allows side- side movement of the foot (inversion & eversion).  Sub Talar Arthrodesis will result in fusion of calcaneus and talus.
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  Pantalar arthrodesis  Pantalararthrodesis refers to surgical fusion of the ankle, subtalar, talonavicu- lar, and commonly the calcaneocuboid joints.
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  Triple Arthrodesis  Triple"arthrodesis refers to a fusion procedure of three joints of the hindfoot and midfoot, the subtalar joint (talus and calcaneus), the talonavicular joint, and the calcaneocuboid joint.
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  Complications of AnkleJoint  Nonunion  10% non union rate  tobacco users have 2.7x risk  neuropathy is greatest risk factor for persistent nonunion with revision of nonunion  Lateral plantar nerve injury  Superficial peroneal nerve  injury to superficial peroneal nerve during transfibular approach  Hindfoot arthritis  adjacent hindfoot arthritis commonly occurs following fusion  isolated hindfoot arthritis due to chronic pes planus is treated with subtalar joint arthrodesis
• 13.
  Alternative to AnkleArthrodesis  Total ankle replacement is a type of joint replacement surgery. It's also called ankle arthroplasty.  Trials are ongoing about efficacy of TAR.  Still preferred modality for ankle arthritis and pain is Ankle Arthrodesis.