Comparing the efficacy of ankle arthrodesis performed through anterior or lateral approaches in end-stage ankle arthritis treatment

Abstract

Purpose: To investigate the clinical efficacy of arthrodesis performed through anterior and lateral approaches for ankle arthritis treatment. Methods: A retrospective analysis of the clinical data of 86 patients with ankle arthritis treated with ankle arthrodesis between January 2019 and December 2022 was conducted. According to the inclusion and exclusion criteria, 65 patients were ultimately included. The ankle osteoarthritis score (AOS), the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scoring system, and alignment changes (medial distal tibial angle (MDTA), anterior distal tibial angle (ADTA), and Talus tilt angle (TTA)) were used to evaluate ankle function before surgery and at the last follow-up. Results: Throughout the follow-up period, there were no significant differences between the two groups in terms of age, sex, operation time, average union time, union rate, total complication rate, or incidence of various types of complications. The AOSs were as follows: anterior approach group, preoperative 57.61 ± 3.64; last follow-up, 19.34 ± 2.19; lateral approach group, preoperative 56.62 ± 3.49; and last follow-up, 19.76 ± 2.39. The AOFAS scores were as follows: anterior approach group, preoperative 38.64 ± 2.52; last follow-up, 79.75 ± 4.85; lateral approach group, preoperative 37.33 ± 2.18; and last follow-up, 80.00 ± 3.70. Both patient groups exhibited good therapeutic effects before and after treatment, and there were no significant differences in the AOSs or AOFAS scores between groups at the last follow-up. Both patient groups exhibited significant changes in MDTA, TTA, and ADTA before and after treatment, and there were no significant differences between groups at the last follow-up. The preoperative TTA (5.02 ± 2.67) of the anterior approach group was smaller than that of the lateral approach group (14.28 ± 5.08), and the difference in TTA correction after different surgical approaches was significant, with the lateral approach treatment being more effective for TTA correction. Conclusion: Both the anterior approach and the lateral approach for the treatment of ankle arthritis can achieve good therapeutic effects, with no significant differences in complications between the two methods, and the lateral approach has good therapeutic efficacy for varus ankle arthritis greater than 10 degrees.