Ankle Arthrodesis Using Fibular Bone Graft: A Depth Meta-analysis from 1991 to 2022.

Background: When conventional approaches are used, ankle arthrodesis can lead to substantial rates of failure or nonunion, especially in high-risk patients. This systematic review evaluates ankle arthrodesis outcomes in individuals receiving fibula transplants. Methods: We have registered our protocol with PROSPERO (CRD42024511245). We did comprehensive searches in both Embase and Medline. The Joanna Briggs Institute (JBI) looked at the quality of the chosen works. A meta-analysis determined the differences between the AOFAS score, full weight-bearing (FWB) time, and bone union. The PRISMA guidelines were used to do this systematic study. Results: We retrieved 291 articles and then selected 20 for meta-analysis and systematic review. A total of 179 patients and ankles were included in the analysis. Eight articles reported a 100% union rate; the remaining four reported that the lowest union rate is about 82%. The AOFAS score significantly increased by 22.5 (95% CI 14.7-30.2) between the preoperative and postoperative evaluations. The average period to complete weight-bearing post-operation and bone healing is about 8.21 months (95% CI: 3.65-12.77) and 5.9 months (95% CI: 3.26-8.54), respectively. Conclusion: Fibular bone graft had a favorable outcome in ankle arthrodesis, including in patients with comorbidities that have bone healing impairment. The union rate showed satisfactory results, and the AOFAS score improved.