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Prospective Comparative Study for Ankle Arthritis Fusion Arthroscopically in Varus Deformities: Efficacy of Deltoid Ligament Release in Deformities > 25 Degrees Versus Deformities < 25 Degrees Without Release

Indian J Orthop. 2025 Jun 27;59(9):1563-1574. doi: 10.1007/s43465-025-01440-3. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Ankle arthrodesis is still the gold standard for painful, dislocated ankles with insufficient response to conservative treatment. This study presents a new arthroscopic solution to treat varus ankles over 25 degrees.

METHODS: Sixty-four patients with varus ankle deformities (35 males, 29 females, 33 right ankles, 31 left ankles) underwent arthroscopic fusion between February 2019 and February 2022. Patients were categorized into Group A (34 patients, varus > 25 degrees) and Group B (30 patients, varus < 25 degrees). The conditions included post-traumatic osteoarthritis (50%), primary osteoarthritis (20.3%), rheumatoid arthritis (17.2%), talar osteonecrosis (7.8%), and talar dome osteochondral defects (4.7%). Outcome measures included ankle joint mobility, radiographic assessment, VAS score, Mazur score, range of motion, stiffness, swelling, union rate, and patient satisfaction at 6, 12, and 24 months postoperative. Statistics analyses were performed using Fisher’s Exact test and Mann-Whitney test.

RESULTS: All procedures were performed successfully and follow-up was 24.08 months on average. VAS and Mazur scores improved significantly in both groups. Group A had a better final outcome than Group B (14.47 weeks for union).

CONCLUSION: The proposed arthroscopic fusion technique can effectively improve the alignment of the tibiotalar joint in varus ankle deformities greater than 25° through medial deltoid release, with promising clinical and functional outcomes.

PMID:41054762 | PMC:PMC12496405 | DOI:10.1007/s43465-025-01440-3

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