Patients Show Faster Recovery and Increased Satisfaction With Arthroscopic Ankle Surgery

Main Category: Bones / Orthopedics
Article Date: 18 May 2005 - 10:00 PDT

email to a friend   printer friendly   opinions  

Orthopaedic surgeons reported the long-term success of arthroscopic surgery to fuse the ankle bones in the April issue of Foot and Ankle International (FAI). The study shows that patients experience less pain and recover faster from this relatively new, less invasive technique than they do with traditional open surgery.

Ankle fusions are performed on patients experiencing severe ankle pain in daily activities when all conservative non-operative treatments have failed. Ankle pain is caused by deterioration that can be due to arthritis of the joint, often from a previous injury that has damaged the joint, because of the wear and tear of everyday activities.

Richard Ferkel, MD, and Michael Hewitt, MD, of the Southern California Orthopaedic institute, conducted the study to evaluate the success of arthroscopic ankle fusion and compare it to results of the open ankle surgery technique.

Dr. Ferkel documented the results of 35 patients with end-stage ankle arthritis who underwent arthroscopic ankle arthrodesis between July 1989 and December 2002. Among these patients, the overall fusion rate was 97% and the average fusion time was 11.8 weeks. There were no infections or neurovascular injuries.

Dr. Ferkel attributes the success of this method to the non-invasive approach, in which an arthroscopic is inserted into the ankle through small incisions. Compared to fusing the ankle bones through an open surgical procedure, the arthroscopic method requires less disruption of the soft tissues. "By not making a big incision it seems to allow better blood supply to the bone and results in faster healing," Dr. Ferkel said.

Patient satisfaction is generally very high with the arthroscopic method. The ideal patient is active enough not to need a total ankle replacement and has no significant malalignment or deformities of the ankle bones. Major malalignment cannot be corrected through the arthroscopic method; however Dr. Ferkel noted that "the technology is improving and we are now able to fix more deformities than ever."

Dr. Ferkel's findings affirm that a patient does not need to go through a big open surgery to achieve ankle fusion. He also wants to dispel rumors that ankle fusion can be debilitating. "A lot of patients are afraid to have an ankle fusion because they think they'll walk with a limp or lose function," he said. A study published in Foot and Ankle International in 2002 showed that after ankle fusions as many as 94% of patients can play golf and some even ski and jog. "It's not nearly as debilitating as people think," Dr. Ferkel noted. "When you watch a patient walk with an ankle fusion, unless you are extremely skilled, you can't tell which ankle was fused,"

Dedicated to advancing research and educational objectives in orthopaedic foot and ankle medicine, the American Orthopaedic Foot and Ankle Society is the leading medical organization for orthopaedic foot care specialists...AOFAS members are the MDs who specialize in the foot and ankle. FAI is published by the American Orthopaedic Foot and Ankle Society (AOFAS).

http://www.aofas.org

• Additional
• References
• Citations