Mini-open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study
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 t...
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Veröffentlicht in: | Indian journal of orthopaedics 2021-05, Vol.55 (Suppl 1), p.135-141 |
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creator | Chinnakkannu, Karthikeyan McKissack, Haley M. He, Jun Kit Alexander, Bradley Wilson, John Viner, Gean C. Shah, Ashish |
description | 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. |
doi_str_mv | 10.1007/s43465-020-00244-x |
format | Article |
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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.</description><identifier>ISSN: 0019-5413</identifier><identifier>EISSN: 1998-3727</identifier><identifier>DOI: 10.1007/s43465-020-00244-x</identifier><identifier>PMID: 34122766</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Conservative Orthopedics ; Medicine ; Medicine & Public Health ; Original ; Original Article ; Orthopedics ; Surgical Orthopedics</subject><ispartof>Indian journal of orthopaedics, 2021-05, Vol.55 (Suppl 1), p.135-141</ispartof><rights>Indian Orthopaedics Association 2020</rights><rights>Indian Orthopaedics Association 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-2ef93842ac88b2e0ad49c4162af15ec468cbaa512f95b1fa77714cd7d9dc4e8d3</citedby><cites>FETCH-LOGICAL-c446t-2ef93842ac88b2e0ad49c4162af15ec468cbaa512f95b1fa77714cd7d9dc4e8d3</cites><orcidid>0000-0001-5806-9498</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149565/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149565/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34122766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chinnakkannu, Karthikeyan</creatorcontrib><creatorcontrib>McKissack, Haley M.</creatorcontrib><creatorcontrib>He, Jun Kit</creatorcontrib><creatorcontrib>Alexander, Bradley</creatorcontrib><creatorcontrib>Wilson, John</creatorcontrib><creatorcontrib>Viner, Gean C.</creatorcontrib><creatorcontrib>Shah, Ashish</creatorcontrib><title>Mini-open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study</title><title>Indian journal of orthopaedics</title><addtitle>JOIO</addtitle><addtitle>Indian J Orthop</addtitle><description>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.</description><subject>Conservative Orthopedics</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Surgical Orthopedics</subject><issn>0019-5413</issn><issn>1998-3727</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU9vFCEYh4nR2G31C3gwHD1IBQaGGQ8mm439Y2o0aY1H8g4wXeosTGFm08YvX3TrRi-eCPk97483PAi9YvSYUareZVGJWhLKKaGUC0HunqAFa9uGVIqrp2hBKWuJFKw6QIc531AqueL1c3RQCca5qusF-vnZB0_i6ALe5mN8lSDk3nfzAAkvxzFFMGvcx3IJPwaHl2lap2hd9vkt_r72JdxTPuPLeXTJF9oH_Cn6MOGvyY2QYPIxvMdLvAILW5fw5TTb-xfoWQ9Ddi8fzyP07eTj1eqMXHw5PV8tL4gRop4Id31bNYKDaZqOOwpWtEawmkPPpDOibkwHIBnvW9mxHpRSTBirbGuNcI2tjtCHXe84dxtnjQtTgkGPyW8g3esIXv-bBL_W13GrGyZaWctS8OaxIMXb2eVJb3w2bhgguDhnzaWgilOlREH5DjUp5pxcv3-GUf3Lmt5Z08Wa_m1N35Wh138vuB_5o6kA1Q7IJQrXLumbOKdQPu1_tQ8KXqYC</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Chinnakkannu, Karthikeyan</creator><creator>McKissack, Haley M.</creator><creator>He, Jun Kit</creator><creator>Alexander, Bradley</creator><creator>Wilson, John</creator><creator>Viner, Gean C.</creator><creator>Shah, Ashish</creator><general>Springer India</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5806-9498</orcidid></search><sort><creationdate>20210501</creationdate><title>Mini-open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study</title><author>Chinnakkannu, Karthikeyan ; McKissack, Haley M. ; He, Jun Kit ; Alexander, Bradley ; Wilson, John ; Viner, Gean C. ; Shah, Ashish</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-2ef93842ac88b2e0ad49c4162af15ec468cbaa512f95b1fa77714cd7d9dc4e8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Conservative Orthopedics</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Surgical Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chinnakkannu, Karthikeyan</creatorcontrib><creatorcontrib>McKissack, Haley M.</creatorcontrib><creatorcontrib>He, Jun Kit</creatorcontrib><creatorcontrib>Alexander, Bradley</creatorcontrib><creatorcontrib>Wilson, John</creatorcontrib><creatorcontrib>Viner, Gean C.</creatorcontrib><creatorcontrib>Shah, Ashish</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Indian journal of orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chinnakkannu, Karthikeyan</au><au>McKissack, Haley M.</au><au>He, Jun Kit</au><au>Alexander, Bradley</au><au>Wilson, John</au><au>Viner, Gean C.</au><au>Shah, Ashish</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mini-open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study</atitle><jtitle>Indian journal of orthopaedics</jtitle><stitle>JOIO</stitle><addtitle>Indian J Orthop</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>55</volume><issue>Suppl 1</issue><spage>135</spage><epage>141</epage><pages>135-141</pages><issn>0019-5413</issn><eissn>1998-3727</eissn><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.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>34122766</pmid><doi>10.1007/s43465-020-00244-x</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-5806-9498</orcidid><oa>free_for_read</oa></addata></record> |
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source | SpringerNature Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
subjects | Conservative Orthopedics Medicine Medicine & Public Health Original Original Article Orthopedics Surgical Orthopedics |
title | Mini-open vs. Transfibular Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study |
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