Arthroscopic TTC Nail Fusion Protocols

A systematic search of 3 databases (the Medical Literature Analysis and Retrieval System Online (Medline), the Excerpta Medica Database (Embase), and Web of Science) and manual search of references was performed through April 4, 2022, by 2 reviewers (DLL and HAK) for literature related to arthroscopy in the context of TTC nail ankle fusion. The search terms included tibiotalocalcan*, arthrodesis, fusion, and arthroscopy. The complete search strategies can be found in Appendix 1. The inclusion criteria for this review were (1) TTC fusion using an intramedullary rod, (2) arthroscopy or the use of minimally invasive arthroscopic portals to prepare the tibiotalar and/or subtalar joint, (3) studies available in English, (4) studies including at least 5 patients, (5) outcomes data provided, (6) 18 years and older, and (7) all levels of evidence. Exclusion criteria consisted of (1) open TTC nail fusion, (2) cadaveric studies, (3) biomechanical studies, (4) no follow-up/outcomes data reported, (5) pediatric population, and (6) systematic reviews. Both arthroscopic (using an arthroscope in particular) and arthroscopic portal (creating portals and using other adjuncts such as fluoroscopy and curettes) joint preparation prior to TTC nailing were included in this study because of the similar small incisions and minimal soft tissue disruption associated with the procedure. For the purposes of this review, both minimally invasive techniques using an arthroscope, or arthroscopic portals with fluoroscopy will be referred to as “transportal TTC nailing.”

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Lameire D.L., Abdel Khalik H., Del Balso C., Daniels T, & Halai M. (2023). Transportal Tibiotalocalcaneal Nail Ankle Arthrodesis: A Systematic Review of Initial Series. Foot & Ankle Orthopaedics, 8(1), 24730114231156422.

Publication 2023

Ankle Arthrodesis Arthroscopic Arthroscopy Fluoroscopy Joint Nail Patients Subtalar joint Tissue

Corresponding Organization : University of Toronto

Other organizations : McMaster University, London Health Sciences Centre, Western University, St. Michael's Hospital

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Variable analysis

independent variables

Use of arthroscopy or arthroscopic portals to prepare the tibiotalar and/or subtalar joint prior to TTC nailing

dependent variables

Outcomes data provided in the studies

control variables

TTC fusion using an intramedullary rod
Studies including at least 5 patients
Patients 18 years and older
All levels of evidence

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