Arthroscopic Ankle Arthrodesis: Current Concepts and Updates
10.14193/jkfas.2025.29.4.131
- Author:
Young Wook SEO
1
;
Young Uk PARK
Author Information
1. Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
- Publication Type:Review Article
- From:Journal of Korean Foot and Ankle Society
2025;29(4):131-138
- CountryRepublic of Korea
- Language:English
-
Abstract:
End-stage ankle arthritis causes severe pain and functional limitations. Although total ankle replacement preserves joint motion, concerns persist regarding implant longevity in younger, active patients, making arthrodesis a mainstay of surgical management. Over three decades, arthroscopic ankle arthrodesis (AAA) has evolved as a minimally invasive alternative to open ankle arthrodesis (OAA). This paper evaluated current trends in AAA, compared outcomes with OAA, and outlined key technical principles. Comparative studies demonstrate that AAA achieves union rates comparable to or exceeding OAA (90%~97%), with shorter hospital stays, reduced blood loss, lower wound complication rates, and faster recovery. Indications have expanded to include selected moderate coronal malalignments when arthroscopic correction is feasible. Essential technical steps involve complete cartilage removal to punctate bleeding bone, asymmetric preparation for deformity correction, and compression-based fixation using two large-diameter screws. Bone grafting is reserved for cases with bone loss, residual gaps, or revision fusion. Nonunion rates (3%~8%) relate primarily to patient comorbidities or inadequate preparation. AAA is a mature technique providing high fusion rates and fewer complications than OAA. Future studies should refine patient selection, optimize fixation constructs, and explore biological augmentation to enhance outcomes.
