CME OnDemand: Novel Imaging and MIS Techniques in Foot and Ankle Care (2026)-MIS Fusions

Video Transcription

Video Summary

Alistair Younger reviews evolving minimally invasive (MIS) and arthroscopic techniques for hindfoot and ankle fusions, emphasizing advances over the past decade such as cartilage burrs and Shannon/wedge burrs to remove cartilage and osteophytes. These tools improve joint access, allow better fusion positioning, and support more stable fixation. He argues MIS is preferable to open surgery primarily to reduce wound complications—often devastating and difficult to manage in remote patients—while also enabling day-case care and potentially improving fusion rates. He cites systematic reviews showing similar operative times and fusion rates, but shorter hospital stays, quicker fusion, and fewer complications with arthroscopic approaches. Younger outlines his arthroscopic ankle fusion setup (supine positioning, thigh tourniquet, multiple portals mindful of neurovascular structures), stepwise debridement of anterior osteophytes and gutters, posterior cartilage removal techniques, and screw fixation strategies. He presents extensions to tibiotalocalcaneal fusion, combined ankle/subtalar fusion, talar avascular necrosis treated with retrograde nail and grafting, Charcot reconstructions, subtalar arthrodesis, and percutaneous triple arthrodesis.

Asset Subtitle

In this lesson, Dr. Alastair Younger presents part two of MIS fusions. Dr. Alastair Younger reviews evolving minimally invasive (MIS) and arthroscopic techniques for hindfoot and ankle fusions, emphasizing advances over the past decade such as cartilage burrs and Shannon/wedge burrs to remove cartilage and osteophytes.

Keywords

minimally invasive ankle fusion

arthroscopic hindfoot arthrodesis

cartilage burr and Shannon burr techniques

tibiotalocalcaneal fusion and retrograde nail fixation

subtalar and triple arthrodesis