No abstract

Despite technologic advances in prosthetic joint replacement, young patients who have lost a large volume of bone or soft tissue because of a tumor or traumatic injury may not be good candidates for prosthetic implants, which have limited longevity relative to that of biologic tissue grafts. In recent years, the use of biologic materials in orthopedic surgery has increased. Such materials, known as allografts, consist of cadaveric bone, cartilage, and other soft tissues that can be transplanted into a living patient. Alternatively, osteochondral autografts, or autologous grafts of the patient's own bone and/or cartilage, can be harvested from one body site and transplanted to another. Surgical procedures range from the local implantation of small osteochondral plugs to the replacement of entire joints with allografts. The size of the allograft used depends on the amount of bone and soft tissue needed. The use of allografts in patients with large-volume bone loss often preserves limb function, obviating amputation, which makes it an attractive option for treatment of young patients. Advantages of using allografts include the similarity of graft materials to native tissues and the decreased patient morbidity in the absence of an autograft donor site; disadvantages include slower biologic remodeling and graft incorporation than are typical with the use of autologous grafts. Potential complications of allograft tissue implantation include graft nonunion, collapse, and failure; infection; and secondary osteoarthritis. The article discusses the indications for and basic steps involved in each type of transplant procedure, normal pre- and postoperative imaging appearances, and imaging features that may be indicative of transplant complications.

The os peroneum is an accessory ossicle within the peroneus longus tendon. Prior reports have discussed fracture of the os peroneum with associated tears of the peroneus longus tendon. When the ossicle fractures, there can be varying degrees of retraction of the tendon, which can be diagnosed by malposition of the ossicle or the ossicle fragments. We report a case of a man with recurrent eversion ankle injuries with progressive retraction of a fractured os peroneum, implying injuries to the superior and inferior peroneal retinacula and the peroneus longus tendon.

Level III, comparative study.