Ausbleibende Fusion nach OSG-Arthrodese: Ursachenanalyse und Lösungsmöglichkeiten

Background

For many decades now, the ankle arthrodesis is still considered and widely accepted by many surgeon as a gold-standard treatment for either an end stage osteoarthritis or posttraumatic osteoarthritis of the Tibiotalar joint because if it’s significant improvement of clinical and functional outcomes. Despite the availability of advanced surgical techniques to fuse the ankle, non-union remains a common complication due to several risk factors. Risk factors associated with failed arthrodesis can be categorised as either patient related or surgical approach related.

Material and Methods

We present an analysis of the aetiology of malunion following surgical fusion of the tibiotalar joint, based on a retrospective review of the literature over the past 20 years. In addition, we present possible solutions based on our own clinical experience, which are comparable to those suggested in previous literature.

Conclusion

Risk factors such as nicotine abuse, diabetes mellitus, Charcot neuroarthropathy, history of open fractures and infections, avascular osteonecrosis, talar malalignment and vitamin D deficiency should be considered by surgeons when planning tibiotalar arthrodesis. Non-compliance also plays an important role in follow-up to achieve a good outcome. It is important to tailor the surgical approach and fixation method to the patient's needs in both primary and revision arthrodesis.