Allografts in Foot and Ankle Surgery

Lewis, John S.; Adams, Samuel B.; Nunley, James A.; Easley, Mark E.

doi:10.2106/jbjs.rvw.m.00034

Cited by 6 publications

(9 citation statements)

References 57 publications

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“…In recent decades, the use of bone allograft has become increasingly common, including for fracture, musculoskeletal tumor, joint instability or arthritic change, deformity correction, and reconstruction. The efficacy and effectiveness of bone allograft use have been confirmed [ 25 , 26 ]. Coetzee et al reported a case series of 44 patients with large talar body defects (after a failed ankle arthroplasty or avascular necrosis) undergoing ankle arthrodesis or tibio-talo-calcaneal fusion by using femoral head allografts [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Midterm outcomes of midfoot and hindfoot arthrodesis with strut allograft for Müller–Weiss disease

Lee

Yang

et al. 2022

BMC Musculoskelet Disord

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Background Müller–Weiss disease (MWD), a rare dysplastic disorder of the foot, is characterized by deformity, sclerosis, and fragmentation of the lateral part of navicular bone. Arthrodesis is the mainstay treatment for MWD. Generally, arthrodesis can be achieved through internal fixation with metallic implants, and morselized chip bone may be packed into the gap for better bone union. However, with this procedure, the original foot size is not maintained and support for the foot arch is not provided. Sequela of short foot, or flatfoot is commonly observed even though these complications of surgery had not been reported with cases of MWD treated by arthrodesis. Herein, we present a retrospective analysis of treating MWD through midfoot and hindfoot arthrodesis combined with strut allograft. Methods From August 2006 to June 2019, 20 patients with MWD (mean age, 59.6 years; range, 40–80 years) underwent midfoot and hindfoot arthrodesis with strut bone allograft and were followed for at least 24 months. The patients were able to ambulate and participate in rehabilitation programs 3 months postoperatively. Results The used four radiographic parameters (Meary’s angle in anteroposterior and lateral view, talonavicular coverage angle, calcaneal pitch) demonstrated significant differences (P < .05) preoperatively and postoperatively, but those between the postoperative values and the values at the last follow-up session did not, indicating that strut allograft was able to maintain normal alignment. The mean American Orthopaedic Foot & Ankle Society Ankle-Hindfoot scores at 2 years postoperatively revealed significant improvement from baseline, from 60.2 to 84.2 (P < .05). The 12-item Short Form Health Survey scores also improved significantly (P < .05). All patients reported substantial pain relief and exhibited improved functional outcomes and gait patterns. Conclusions For advanced-stage MWD, arthrodesis with a precisely shaped, size-matched strut allograft provided strong support for biomechanical alignment and enhanced functional performance.

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Section: Discussionmentioning

confidence: 99%

Midterm outcomes of midfoot and hindfoot arthrodesis with strut allograft for Müller–Weiss disease

Lee

Yang

et al. 2022

BMC Musculoskelet Disord

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“…Structural tissue allograft use in foot and ankle surgery is a widely accepted and described method to fill substantial osseous defects and correct deformities of the foot and ankle. 23,25,26 The femoral head has become a popular allograft source in the past several decades for many fields of orthopaedic surgery, [27][28][29] including foot and ankle surgery, where it has become a recognized method to fill extensive osseous defects in ankle and hindfoot regions during arthrodesis. 23,[30][31][32][33][34] However, sufficient reporting of outcomes for many of these techniques is still lacking.…”

Section: Discussionmentioning

confidence: 99%

“…23,[30][31][32][33][34] However, sufficient reporting of outcomes for many of these techniques is still lacking. 14,26 Femoral head allograft is primarily advantageous because of the ample availability, the large volume of bone it provides for structural support, and diminished requirement of autograft bone harvests associated with donor site morbidity. 23,26,32,33,35,36 With the increasing popularity of total ankle replacement and the potential increasing need for salvage procedures, review of outcomes after TTC arthrodesis with large bone voids is pertinent.…”

Section: Discussionmentioning

confidence: 99%

“…14,26 Femoral head allograft is primarily advantageous because of the ample availability, the large volume of bone it provides for structural support, and diminished requirement of autograft bone harvests associated with donor site morbidity. 23,26,32,33,35,36 With the increasing popularity of total ankle replacement and the potential increasing need for salvage procedures, review of outcomes after TTC arthrodesis with large bone voids is pertinent. The goals of this study were to assess the radiographic and clinical outcomes of TTC arthrodesis with bulk femoral head allograft as well as identify predictive factors that may influence outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Midterm Results of Radiographic and Functional Outcomes After Tibiotalocalcaneal Arthrodesis With Bulk Femoral Head Allograft

Rogero

Tsai

Fuchs

et al. 2019

Foot & Ankle Specialist

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Background: Tibiotalocalcaneal (TTC) arthrodesis implementing adjunctive allografts is a method of limb salvage for patients with complex hindfoot osseous deficits, though outcome results are limited. The purposes of this study were to assess functional and radiographic outcomes after TTC arthrodesis with femoral head allograft and retrospectively identify prognostic factors. Methods: The authors reviewed 24 TTC arthrodesis procedures with bulk femoral head allografts performed by a single surgeon from 2004 to 2016. Radiographic union at the ankle and subtalar joints along with stability of the allograft were assessed. Patients who had clinically successful arthrodeses were contacted to score the Foot and Ankle Ability Measure—Activities of Daily Living (FAAM-ADL) questionnaire, Visual Analog Scale (VAS) for pain, and Short Form-12 (SF-12) at a mean of 58.0 months (range, 28-102) postoperatively. Results: Complete radiographic union of involved joints was achieved in 15 patients (63%) and in 75% (36/48) of all joints; 21 ankles (88%) were assessed to be radiographically stable at final follow-up. Three patients (13%) underwent revision arthrodesis at a mean of 18.9 months postoperatively, and 21 patients (88%) did not require additional surgery as of final follow-up. Patients significantly improved to a mean FAAM-ADL score of 71.5 from 36.3 (P < .001). The mean VAS for pain significantly improved from 77.2 to 32.9 (P < .001). Male sex (P = .08) and a lateral operative approach (P = .03) both resulted in worse outcomes. Conclusion: Use of a femoral head allograft with TTC arthrodesis can offer improved functional scores and sustained radiographic outcomes. Level of Evidence: Level IV: Case series

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“…However, the quality of published evidence supporting the use of allograft transplantation in foot and ankle surgery has been reported as fair [5].…”

Section: Introductionmentioning

confidence: 99%

Structural allograft reconstruction of the foot and ankle after tumor resections

et al. 2016

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Allografts in Foot and Ankle Surgery

Cited by 6 publications

References 57 publications

Midterm outcomes of midfoot and hindfoot arthrodesis with strut allograft for Müller–Weiss disease

Midterm outcomes of midfoot and hindfoot arthrodesis with strut allograft for Müller–Weiss disease

Midterm Results of Radiographic and Functional Outcomes After Tibiotalocalcaneal Arthrodesis With Bulk Femoral Head Allograft

Structural allograft reconstruction of the foot and ankle after tumor resections

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