Ankle Arthrodesis Fusion Rates for Mesenchymal Stem Cell Bone Allograft Versus Proximal Tibia Autograft

Anderson, John J.; Boone, Joshua J.; Hansen, Myron; Brady, Chad; Gough, Adam; Swayzee, Zflan

doi:10.1053/j.jfas.2014.06.029

Cited by 21 publications

(17 citation statements)

References 15 publications

(13 reference statements)

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“…The use of bone graft with internal or external compression will enhance the likelihood of a successful arthrodesis [31, 35–37]. In studies ranging in size from 12 to 101 patients, rates of successful primary ankle fusion of 80–100% have been reported.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic arthrodesis for ankle arthritis without bone graft

2016

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BackgroundAnkle arthrodesis is considered by many to be the standard operative treatment for end-stage ankle arthritis. The purpose of this study was to perform a new technique for ankle joint surface and determine the outcome for the union rates of ankle arthroscopic arthrodesis.MethodsA total of 68 patients with posttraumatic arthritis, primary osteoarthritis, and rheumatoid arthritis were treated by ankle arthroscopic arthrodesis between May 2007 and December 2012. Our surgical indication was deformity less than 15° measured by weight-bearing radiographs. Firstly, the remaining articular cartilage was removed with different curettes and shavers. Then, the new technique (microfracture) was done at tibiotalar surfaces. Finally, the ankle was fixed with two cannulated percutaneous screws. The wound healing, complications, postoperative radiographs, and American Orthopaedic Foot and Ankle Society (AOFAS) score were evaluated.ResultsThe average follow-up time was 32 months (range 25–58 months). There was no bone grafting, and a fusion rate of 100% was achieved. The average fusion time was 12.1 weeks. One patient developed superficial infection at 2 weeks postoperatively and was cured by nonsurgical treatment. No deep infections, deep venous thrombosis, or revision surgery were observed. Screws had been removed in four patients because of prominence. One patient had fusion in the subtalar joint because of arthritis at 5 years postoperatively. At the last follow-up, radiographic signs of developed or progressing arthritis were observed in nine patients at subtalar joint and in four patients at talonavicular joint. At 1-year follow-up, the mean AOFAS ankle/hindfoot score had increased to 84 from a mean preoperative value of 38 (P < 0.01).ConclusionsArthroscopic arthrodesis provides surgeons with an alternative to traditional open techniques for the management of severe ankle arthritis. Our data show that preparation of the joint surface with microfracture is an effective technique to increase the union rate of arthroscopic ankle arthrodesis, while bone graft and other promoting substances are not necessary to be routinely used.Electronic supplementary materialThe online version of this article (doi:10.1186/s13018-016-0490-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic arthrodesis for ankle arthritis without bone graft

2016

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“…The per protocol current study of 92 subjects (153 arthrodeses) is substantially larger than other published foot and ankle fusion studies that used allograft or synthetic bone void filler, which ranged from 10 to 47 subjects (10-80 joints). 2,5,13,29,31,32 CT images provide a higher resolution of the bony fusion than plain films and are preferred among radiologists and surgeons because they are more accurate and reliable than plain radiographs. 16,33 Additionally, radiological assessment by an observer blinded to the clinical result is favored because assessment by the treating surgeon is considered unreliable.…”

Section: Discussionmentioning

confidence: 99%

Prospective, Multicenter Evaluation of Allogeneic Bone Matrix Containing Viable Osteogenic Cells in Foot and/or Ankle Arthrodesis

et al. 2015

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“…24 Allografts are widely used and available to augment fusion, 22 but studies comparing autograft and allograft are varied in the type of graft used and in sample size. Anderson et al 3 showed that although their autograft cohort had faster fusions (clinically and radiographically), they found no difference in overall ROF or patient satisfaction when comparing autografts with allografts. DiDomenico and Thomas, in their review of the literature comparing autograft with osteobiologic agents, also noted no reports of differences in fusion rates, willingness to repeat the procedure, or patient satisfaction.…”

Section: Discussionmentioning

confidence: 96%

Comparing Rates of Fusion and Time to Fusion in Viable Cellular Allograft and Autograft

et al. 2022

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Background: Autograft or allograft frequently are used to enhance bone union in foot and ankle surgery. Viable cellular bone allograft uses viable cells and bone scaffolding in a gel base, but uncertainty remains around allograft’s greater efficacy than autograft regarding rates of fusion (ROF) and time to fusion (TTF). Methods: Autograft, viable cellular allograft, and viable cellular allograft with autograft were compared in 199 forefoot, midfoot, and hindfoot arthrodeses performed over a 6-year period. Data collected from electronic medical records and radiographs were analyzed to determine ROF and TTF as well as rates of revision surgery for delayed or nonunion and compared among groups. Results: Eighty-seven patients comprised the autograft group, 81 the allograft group, and 31 the combined group. No significant differences were noted in patient demographics among the groups. No statistically significant differences in ROF were noted among the 3 groups, with 86% (75 of 87) fusion in the autograft group, 93% (75 of 81) in the allograft group, and 84% (26 of 31) in the combined group ( P = .20). After conducting a multivariate analysis, we found no statistically significant difference for allograft or combined graft on TTF ( P = .1379 and .2311, respectively). No significant difference was found in rate of revision surgery for nonunion, which was 1.2% (1 of 81) in the allograft group, 3.4% (3 of 87) in the autograft group, and 6.5% (2 of 31) in the combined group ( P = .3). Conclusion: No significant difference was found in ROF, TTF, or rate of revision surgery when comparing viable cellular allograft to autograft or combined allograft-autograft. Viable cellular allograft may be a reasonable alternative to the gold standard of autograft and should be considered an option in patients undergoing arthrodesis in foot and ankle surgery. Level of Evidence: Level III, therapeutic.

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Ankle Arthrodesis Fusion Rates for Mesenchymal Stem Cell Bone Allograft Versus Proximal Tibia Autograft

Cited by 21 publications

References 15 publications

Arthroscopic arthrodesis for ankle arthritis without bone graft

Arthroscopic arthrodesis for ankle arthritis without bone graft

Prospective, Multicenter Evaluation of Allogeneic Bone Matrix Containing Viable Osteogenic Cells in Foot and/or Ankle Arthrodesis

Comparing Rates of Fusion and Time to Fusion in Viable Cellular Allograft and Autograft

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