Ankle arthrodesis: A systematic approach and review of the literature

Core Tip

Core tip: Ankle arthrodesis is an effective treatment option for end stage arthritis. There is no current consensus on the most optimal approach and fixation method. It is thus important for the surgeon to understand both the open and arthroscopic approach and when each approach is indicated. Joint alignment must be slightly valgus (0°-5°), neutrally dorsiflexed and slightly in an externally rotated position. Limb length discrepancies should also be minimal (less than 2.5 cm or 1.0 inch). Failure to address these biomechanical aspects may result in pain and an altered gait pattern. The importance of adequate preoperative forefoot balance cannot be understated to allow for successful postoperative mobility. When performed according to these principles ankle arthrodesis leads to functional improvement and adequate joint fusion in patients with end stage arthritis.