Management of early ankle osteoarthritis through anterior joint-preserving surgery: a retrospective evaluation at mid- to long-term follow-up

Eur J Orthop Surg Traumatol. 2020 Oct;30(7):1171-1178. doi: 10.1007/s00590-020-02691-6. Epub 2020 May 3.

Abstract

Purpose: Chronic anterior ankle pain is a recognized and straightforward characteristic of anterior impingement syndrome. This retrospective study aims to evaluate outcomes, clinical and radiological results in patients affected by anterior ankle impingement, in a context of early osteoarthritis, and treated with mini-open anterior ankle arthrolysis, in the perspective to delay or avoid other demolitive surgical options, such as total ankle replacement and joint fusion.

Methods: In total, 49 patients (50 feet, mean age 45 years) undergone mini-open anterior ankle arthrolysis for anterior impingement, fulfilled inclusion criteria and gave their consent and have been enlisted in the study. Patients were retrospectively reviewed with AOFAS ankle-hindfoot score and SF-36 score at a minimum follow-up of 36 months. Statistical analysis was performed.

Results: A marked improvement was noticed in terms of preoperative clinical score (mean AOFAS score 47.32 ± 17.89) compared to follow-up clinical score (mean AOFAS score 70.66 ± 16.62; p < 0.005), and all of 8 SF-36 domains showed statistically improved (p < 0.05) from preoperative to follow-up. Statistical significance has been shown.

Conclusions: It is possible to consider the mini-open anterior arthrolysis, thanks to the reduction of the painful symptomatology, a valid tool for procrastinating more invasive interventions such as arthrodesis or prosthetic replacement in patients with grade 1 or 2 of ankle osteoarthritis.

Keywords: Ankle; Anterior impingement; Arthrolysis; Open; Osteoarthritis.

MeSH terms

  • Ankle Joint / diagnostic imaging
  • Ankle Joint / surgery
  • Ankle*
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Osteoarthritis* / diagnostic imaging
  • Osteoarthritis* / surgery
  • Retrospective Studies
  • Treatment Outcome