David Townshend, MBBS, FRCS; Matthew Di Silvestro, MSc, MD, FRCSC

Fabian Krause, MD,Murray Penner, MD, FRCSC; Alastair Younger, MBChB, FRCSC

Mark Glazebrook, MSc, PhD, MD, FRCSC, Dip Sports Med; Kevin Wing, MD, FRCSC

Abstract
Background:  
Ankle arthrodesis results in measurable improvements in terms of pain and function in patients with end-stage ankle arthritis. Arthroscopic ankle arthrodesis has gained increasing popularity, with reports of shorter hospital stays, shorter time to solid fusion, and equivalent union rates when compared with open arthrodesis. However, there remains a lack of high-quality prospective data.

Methods:  
We evaluated the results of open and arthroscopic ankle arthrodesis in a comparative case series of patients who were managed at two institutions and followed for two years. The primary outcome was the Ankle Osteoarthritis Scale score, and secondary outcomes included the Short Form-36 physical and mental component scores, the length of hospital stay, and radiographic alignment. There were thirty patients in each group.

Results:  
Both groups showed significant improvement in the Ankle Osteoarthritis Scale score and the Short Form-36 physical component score at one and two years. There was significantly greater improvement in the Ankle Osteoarthritis Scale score at one year and two years and shorter hospital stay in the arthroscopic arthrodesis group. Complications, surgical time, and radiographic alignment were similar between the two groups.

Conclusions:  
Open and arthroscopic ankle arthrodesis were associated with significant improvement in terms of pain and function as measured with the Ankle Osteoarthritis Scale score. Arthroscopic arthrodesis resulted in a shorter hospital stay and showed better outcomes at one and two years.

Level of Evidence:  
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.