Tibiotalar Arthrodesis

Arthrodesis remains an acceptable and reliable treatment for recalcitrant ankle arthritis. Although historically stabilized with the use of casts, internal fixation with compression screws is now the norm. Cases with minimal deformity can be approached in a minimally invasive fashion. Advanced deformity or a failed total ankle replacement necessitates a lateral or anterior approach. The overall fusion rate in the modern literature exceeds 90%, especially with minimally invasive techniques. Potential complications include nonunion, malunion, infection, and adjacent joint arthritis and can be minimized with careful attention to surgical technique, including rigid internal fixation and proper alignment of the fusion.