Revision Ankle Arthrodesis

Abstract

Between 1996 and 1999, we performed successful revision ankle arthrodesis for aseptic nonunion in 10 patients using external fixation with bone graft and an implantable bone stimulator. The etiology of the ankle arthrosis in the patients was post-traumatic in eight and rheumatologic in two. The average age of the patients was 54. On average, each patient had received 2.5 previous surgeries (range, 1 to 5) prior to the original fusion attempt.

Fusion occurred in all 10 of these patients at an average of 12.8 weeks following revision (range, nine to 20 weeks). Complications occurred in two patients: one had a pin tract infection which resolved with local pin care and oral antibiotics; the second patient had a varus malalignment which was accommodated with orthotics. This patient also had a deep peroneal nerve neuropraxia which resolved with observation.

We evaluated all 10 patients with clinical and radiographic examination, and determined their functional results for a duration of follow-up of 15 months (range, six to 36 months). Using a modification of the AOFAS ankle/hindfoot scoring system, the results were: three excellent, four good, two fair, and one poor. All but one of these patients were satisfied with the outcome of this procedure. Radiographic analysis supported good clinical alignment and solid fusion.