PMC7481886_01
Preoperative standing radiographs of both ankles showing advanced arthropathy with narrowing of the joint space, erosions of the articular margins, and incongruity of the joint surfaces in (a) anteroposterior view and (b) lateral view.
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Weightbearing radiographs revealed narrowed joint spaces in weightbearing areas in both ankles (Fig. 1a, b), although ankle alignment was almost neutral.
Computed tomography shows cystic lesions and an irregular articular surface at both the tibia and talus on (a) coronal view and (b) sagittal view.
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Computed tomography (CT) showed cystic regions in the weightbearing areas of the tibia and talus and an irregular articular surface (Fig. 2a, b).
Intraoperative findings show (a) peeling of the cartilage from the tibia and talus in both ankles and (b) bleeding from numerous dimples on the talus and tibial plafond.
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Cartilage remnants at the talus and tibia (Fig. 3a) were easily removed using a shaver and curette. The upper surface of the talus and lower surface of the tibial plafond were then abraded to remove sclerotic bone, creating dimples on the tibial and talar subchondral bone that were confirmed to bleed (Fig. 3b). Arthroscopic findings of the right ankle were very similar to those at the left ankle (Fig. 3a, b).
Radiograph of the right ankle at 1 year after surgery shows bony fusion with complete obliteration of the joint space.
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At the 1-year follow-up visit, bony union was adequate and there was no radiologic evidence of screw loosening, defined as the presence of bridging trabeculae across the arthrodesis (Fig. 4a, b).