DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20212427

Comparative study between Blair’s procedure of ankle fusion and arthroscopic ankle arthrodesis

Daya Krishna, Gunjan Upadhyay, Alok Kumar, Chandra Mohan Singh Rawat

Abstract


Background: Our objective was to perform a comparative study in terms of functional outcome of Blair’s procedure of ankle fusion versus arthroscopic methods of ankle fusion.

Methods: 25 patients that underwent arthroscopic ankle arthrodesis versus Blair’s procedure of ankle fusion were taken for study at government medical college, Srinagar (VCSGGIMS and R) from the duration 2015-2021. Clinical assessment was done foot and ankle disability index and visual analog scale score for pain. Radiological assessment was done by serial X-rays. Regular follow-ups were taken till one year.

Results: Both modalities proved to be equally effective in terms of patient’s functional outcome. Our analysis showed that Blair’s procedure ankle fusion was associated with a lower fusion rate (OR 0.26, 95% CI 0.13-0.52, p=0.0002), longer tourniquet time (MD 16.49, 95% CI 9.46-23.41, p<0.00001), and longer length of stay (MD 1.60,95% CI 1.10-2.10, p<0.00001) compared to arthroscopic ankle fusion; however, there was no significant difference between two groups in terms of infection rate (OR 2.41, 95% CI 0.76-7.64, p=0.14), overall complication rate (OR: 1.54, 95% CI 0.80-2.96, p=0.20), and operation time (MD 4.09, 95% CI 2.4910.66, p=0.22).

Conclusions: We found no significant difference between two groups in terms of infection rate, overall complication rate, and operation time. Further high quality randomized controlled trials that are adequately powered are required.


Keywords


Blair’s procedure, Ankle, Arthrodesis, Arthroscopic, Ankle fusion

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References


Coester LM, Saltzman CL, Leupold J, Pontarelli W. Long-term results following ankle arthrodesis for post-traumatic arthritis. J Bone Joint Surg Am. 2001;83(2):219-28.

SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following, ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg Am. 2007;89(10):2143-49.

Glazebrook M, Daniels T, Younger A. Comparison of health-related quality of life between patients with end-stage ankle and hip arthrosis. J Bone Joint Surg Am. 2008;90(3):499-505.

Thomas R, Daniels TR, Parker K. Gait analysis and functional outcomes following ankle arthrodesis for isolated ankle arthritis. J Bone Joint Surg Am. 2006;88(3):526-35.

Myerson MS, Quill G. Ankle arthrodesis. A comparison of an arthroscopic and a Blair’s procedure method of treatment. Clin Orthop Relat Res. 1991;268:84-95.

Ferkel RD, Hewitt M. Long-term results of arthroscopic ankle arthrodesis. Foot Ankle Int. 2005;26(4):275-80.

Chapter 8: assessing risk of bias in included studies. In: Higgins DG, Altman JP, eds. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.0.1. Updated September 2008. Available at: http://hiv.cochrane.org/sites/hiv. cochrane.org/files/uploads/Ch08_Bias.pdf. Accessed May 15, 2020.

Wells GA, Shea B, O’Connell D. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Non randomized Studies in Meta-analyses. Available at: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed May 15, 2020.

Meng Q, Yu T, Yu L, Zhao X, Qi C. Effectiveness comparison between arthroscopic and Blair’s procedure ankle arthrodeses. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013;27(3):288-91.

Townshend D, Di Silvestro M, Krause F. Arthroscopic versus Blair’s procedure ankle arthrodesis: a multicenter comparative case series. J Bone Joint Surg Am. 2013;95(2):98-102.

Peterson KS, Lee MS, Buddecke DE. Arthroscopic versus Blair’s procedure ankle arthrodesis: a retrospective cost analysis. J Foot Ankle Surg. 2010;49(3):242-7.

Nielsen KK, Linde F, Jensen NC. The outcome of arthroscopic and Blair’s procedure surgery ankle arthrodesis: a comparative retrospective study on 107 patients. Foot Ankle Surg. 2008;14(3):153-7.

O'Brien TS, Hart TS, Shereff MJ, Stone J, Johnson J. Blair’s procedure versus arthroscopic ankle arthrodesis: a comparative study. Foot Ankle Int. 1999;20(6):368-74.

Liberati A, Altman DG, Tetzlaff J. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.

Winson IG, Robinson DE, Allen PE. Arthroscopic ankle arthrodesis. J Bone Joint Surg Br. 2005;87-B(3):343-7.

Collman DR, Kaas MH, Schuberth JM. Arthroscopic ankle arthrodesis: factors influencing union in 39 consecutive patients. Foot Ankle Int. 2006;27(12):1079-85.

Zvijac JE, Lemak L, Schurhoff MR. Analysis of arthroscopically assisted ankle arthrodesis. Arthroscopy. 2002;18(1):70-5.

Fuchs S, Sandmann C, Skwara A. Quality of life 20 years after arthrodesis of the ankle: a study of adjacent joints. J Bone Joint Surg Br. 2003;85-B:5-B:994-8.

Ogilvie-Harris DJ, Lieberman I, Fitsialos D. Arthroscopically assisted arthrodesis for osteoarthrotic ankles. J Bone Joint Surg Am. 1993;75(8):1167-74.

Stone JW. Arthroscopic ankle arthrodesis. Foot Ankle Clin. 2006;11(2):361-8.

Gougoulias NE, Agathangelidis FG, Parsons SW. Arthroscopic ankle arthrodesis. Foot Ankle Int. 2007;28(6):695-706.