Subtalar Distraction Arthrodesis with Fresh Frozen Femoral Neck Allograft

Abstract

Therapeutic, Level IV: Case series.

Systematic Review of Subtalar Distraction Arthrodesis for the Treatment of Subtalar Arthritis

“…Anterograde fixation was also utilized by Amendola et al 3 with no reported cases of hardware removal. Most recently, Monaco et al 24 described the use of partially threaded, headless, cannulated positional screws and emphasized the importance of placement in the nonweightbearing area of heel.…”

“…Tricortical autologous iliac crest bone graft is the most common graft used in SDA. Other graft types used include local autograft from the lateral calcaneal wall exostectomy, 2,12,17,27,29 femoral head allograft, 10,18,22,24,32 iliac crest allograft, 22,27 freeze-dried bovine xenograft, 19 and porous tantalum. 26 Most commonly described is a trapezoid or wedge-shaped bone block with the graft tallest medially and posteriorly (laterally and anteriorly tapered) 3,9,18,25 to prevent the complication of varus malpositioning.…”

“…22 Chiang et al also recently reported a 100% union rate with the use of femoral head allograft without orthobiologic agents, although they did augment with local autograft from the lateral calcaneal wall. 10 In 2016, Monaco et al 24 reported 100% union rate with the use of fresh-frozen femoral neck allograft without any adjuvant modalities. 24 The trend toward allograft avoids the harvest site morbidity that is reported, including persistence of donor site pain.…”

“…15 More recent studies have found that allograft had equivalent § § References 3,6,7,10,11,18,19,26,27,30,32. ¶ ¶ References 2,3,6,[9][10][11]18,19,24,26,27,30,32. union rates to structural autograft.…”

“…Data from all 25 studies were included in the demographic and statistical analyses for a total of 492 subtalar distraction arthrodesis in 467 patients. [2][3][4][5][6][7][8][9][10][11][14][15][16][17][18][19][22][23][24][25][26][27][28][29][30]32…”