A Retrospective Analysis of Outcomes From Foot and Ankle Arthrodesis and Open Reduction and Internal Fixation Using Cellular Bone Allograft Augmentation

Abstract

Background ViviGen is an allogeneic cellular bone matrix product containing lineage-committed bone cells, and can be used as an alternative to autograft bone or other augments to aid in arthrodesis or to enhance bony healing in open reduction and internal fixation (ORIF) procedures. Methods This study included 153 consecutive patients undergoing ankle, midfoot, or hindfoot arthrodesis or ORIF procedures from January 2017 to October 2018, in which an allogeneic cellular bone matrix product was used to aid in bony healing. Retrospective chart review identified patient demographic factors and medical comorbidities and evaluated clinical and radiographic data to determine fusion/union rate and complications. Results The overall fusion rate for the arthrodesis cohort was 97/113 (85.8%). The overall complication rate in this cohort was 22/113 (19.5%). Smokers had significantly lower rates of fusion compared with nonsmokers ( P = .01). The observed bony healing rate for the ORIF cohort was 19/22 (86.4%), with a complication rate of 3/22 (13.6%). Conclusion With satisfactory fusion rates and relatively few complications, our findings suggest that ViviGen is a safe and efficacious alternative to other forms of bone graft augmentation for fusion and ORIF procedures about the foot and ankle. Further study is needed to compare the efficacy of ViviGen with autograft bone and other augments. Levels of Evidence: Level IV: Case series

Clinical and Radiologic Outcome of First Metatarsophalangeal Joint Arthrodesis Using a Human Allogeneic Cortical Bone Screw

“… 2 , 16 , 27 Biological augmentation of arthrodesis in foot and ankle surgery using allogenic bone shows satisfying results and high fusion rates without experiencing adverse events because of its osteoconductive potential. 24 , 33 Other bone augmentation materials such as demineralized bone matrix (DBM) consisting of a collagen scaffold and several growth factors, most importantly bone morphogenetic proteins, result in a high positive turnover. 35 Thus, DBM can actively induce bone formation by its osteoinductive potential following endochondral ossification because of the recruitment of mesenchymal stem cells from bone.…”

Characterization of an advanced viable bone allograft with preserved native bone-forming cells

“…V-BC within the bone matrix do not stain positive for MHCII, suggesting V-BC are nonimmunogenic and providing an explanation of the lack of immune cell activation in the MLR assay. 10 × magnification; insets show magnified area of stained bone matrix several studies have demonstrated success using VBA in patients with comorbidities (Moran et al 2020;Roukis 2018;Roukis and Samsell 2018;Roukis et al 2020). In particular, Moran, et al (2020) reported an 86% fusion rate in 135 high-risk patients, which was similar to fusion rates reported with the use of autograft (Lareau 2015; Muller 2013).…”

“…10 × magnification; insets show magnified area of stained bone matrix several studies have demonstrated success using VBA in patients with comorbidities (Moran et al 2020;Roukis 2018;Roukis and Samsell 2018;Roukis et al 2020). In particular, Moran, et al (2020) reported an 86% fusion rate in 135 high-risk patients, which was similar to fusion rates reported with the use of autograft (Lareau 2015; Muller 2013). Likewise, in spinal fusion, in addition to patient comorbidities and lifestyle risk factors, the number of levels to be fused can add to the complexity of a case and potentially limit the ability to achieve successful fusion.…”

Immediate Mandibular Reconstruction Using a Cellular Bone Allograft Following Tumor Resection in a Pediatric Patient

“…By providing all 3 essential bone remodeling properties, VF-CBA facilitated fusion at the defect site. Although VF-CBA has been used successfully to achieve fusion in spine and orthopedic applications, [13][14][15][16][17][18] its use in oral and maxillofacial surgery is an emerging application, [19][20][21] and in particular, to our knowledge, has not yet been shown in a pediatric patient. Therefore, this is the first known report of a successful immediate reconstruction of a large segmental mandibular defect using VF-CBA in a young child.…”