CME OnDemand: 2022 AOFAS Annual Meeting-3-Year Follow-Up of Arthroscopic Debridement and Interposition with Acellular Allograft Dermal Matrix for Ankle Arthritis with Anterior Impingement

3-Year Follow-Up of Arthroscopic Debridement and Interposition with Acellular Allograft Dermal Matrix for Ankle Arthritis with Anterior Impingement

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Pdf Summary

The study examines the use of arthroscopic debridement and interposition with acellular allograft dermal matrix for ankle arthritis with anterior impingement. The study includes 12 patients and follows them for 3 years. The inclusion criteria for the study are patients between the ages of 18-65 with post-traumatic ankle degeneration who have previously tried ankle-foot-orthosis. The exclusion criteria include diabetics, patients with inflammatory joint arthropathy, infection, significant deformity, and smokers. The surgical technique involves the use of acellular dermal matrix in both open and arthroscopic techniques. The patients undergo a day case procedure under general anesthesia and popliteal regional block. The graft jacket is maneuvered into the joint and secured in place with Tisseal fibrin glue. The post-operative care involves thromboembolic prophylaxis, immobilization with a moonboot, and gradual weight-bearing. The study reports 2 conversions to total ankle replacement and 1 conversion to tibial opening wedge plafondplasty at 2 years, with no infections or conversions to fusion. The conclusion suggests that arthroscopic interposition arthroplasty with dermal matrix can provide pain relief and increased mobility for 2-5 years while preserving future surgical options. Further prospective trials are recommended. Overall, the study suggests that this procedure could be a useful option for young patients with ankle degeneration who are not ready for major surgery.

Asset Subtitle

Roslyn Miller, MB ChB, FRCS(Ed), FRCS(Tr&Oth)

Keywords

arthroscopic debridement

interposition

acellular allograft dermal matrix

ankle arthritis

anterior impingement

post-traumatic ankle degeneration

ankle-foot-orthosis

surgical technique

graft jacket

thromboembolic prophylaxis