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Mini-open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study

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Abstract

Background

Arthrodesis is considered the gold standard for end-stage ankle arthritis in patients who fail conservative management. Achieving union is paramount while minimizing complications. An essential item for successful union is preparation of the articular surface. Our study aims to evaluate the difference in joint preparation between direct lateral and dual mini-open approaches.

Materials and Methods

Ten below knee fresh-frozen specimens were used for this study. Five were prepared through lateral approach, and five using dual mini-incisions. After preparation, all ankles were dissected and images of tibial plafond and talar articular surfaces were taken. Surface areas of articulating facets and unprepared cartilage of talus, distal tibia, and distal fibula were measured and analyzed.

Results

A greater amount of total surface area was prepared with the mini-open approach in comparison to the transfibular approach. Percentage of prepared surface area of total articulating surface (including talus and tibia/fibula), talus, tibia, and fibula with the transfibular approach were 76.9%, 77.7%, and 75%, respectively. Percentages were 90.9%, 92.9%, and 88.6% with the mini-open approach. When excluding medial gutter, there was no significant difference between techniques (83.94% vs. 90.85%, p = 0.1412).

Conclusion

Joint preparation with the mini-open approach is equally efficacious as the transfibular approach for the tibiotalar joint. The mini-open approach does provide superior preparation of the medial gutter and inferior tibial surface which may help to increase union rates and decreased complications.

Level of Evidence

V.

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The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Alabama at Birmingham, 1313 13th Street South, Birmingham, AL, 35205, USA

    Karthikeyan Chinnakkannu, Haley M. McKissack, Jun Kit He, Bradley Alexander, John Wilson, Gean C. Viner & Ashish Shah

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  1. Karthikeyan Chinnakkannu
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  2. Haley M. McKissack
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  3. Jun Kit He
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  4. Bradley Alexander
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  5. John Wilson
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Correspondence to Ashish Shah.

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Chinnakkannu, K., McKissack, H.M., He, J.K. et al. Mini-open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study. JOIO 55 (Suppl 1), 135–141 (2021). https://doi.org/10.1007/s43465-020-00244-x

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  • DOI: https://doi.org/10.1007/s43465-020-00244-x

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