Initial Experience with Tricortical Iliac Crest Bone Graft and Human Amniotic Allograft in Evans Calcaneal Osteotomy

Anderson, John J.; Gough, Adam; Hansen, Myron; Swayzee, Zflan

doi:10.4236/scd.2015.52002

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…The authors have used amniotic or human allograft derived from amniotic tissue in several surgical applications with exceptional results [24]. With previous success, we applied these principals to using HAA to improve the body's ability to recover and replace tissue from simple fibrocartilage to a more quality cartilage defect replacement such as a mix of hyaline or fiber cartilage [19] [20].…”

Section: Introductionmentioning

confidence: 99%

Human Amniotic Allograft in Use on Talar Dome Lesions: A Prospective Report of 37 Patients

Anderson¹,

Swayzee²,

Hansen³

2014

SCD

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One of the most challenging joint conditions facing ankle surgeons today is the treatment of Osteochondritis Dissecans (OCD) of the talar dome. The use of human amniotic allograft (HAA) in various surgical procedures, has been proven to facilitate bone growth and both soft tissue and cartilage healing. The authors of this paper propose the addition of HAA to the surgical repair of talar dome lesions to improve postoperative results, specifically pain reduction. For the study, 37 patients were identified having an OCD lesion of the talus measuring no larger than 2 cm 2 . All patients were treated surgically with an arthroscopic micro-fracture repair along with the addition of HHA. Modified ACFAS ankle scores were taken pre-operatively and at 3 months, 12 months, and at 24 months postoperatively. Visual analog scores were also taken preoperative and 24 months postoperatively. The size of the talar lesions documented with pre-operative MRI's was compared with intra-operative measurements for each patient. Additional surgical repairs, comorbidities and any complications were also recorded and evaluated. All patients were treated with micro-fracture with HAA. Postoperative ACFAS scores for 3 months, 12 months and 24 months were significantly improved (p < 0.0001) compared with average preoperative scores. Additionally, VAS scores were also significantly improved when comparing the average pre-operative (4.9) and post-operative (1.1) pain scores (p < 0.0001). The size of the lesions documented by pre-operative MRI correlated to intra-operative measurements. There were no identified complications. The addition of HAA to arthroscopic micro-fracture repair of talar dome lesions measuring less than 2 cm 2 has shown to significantly improve both post-operative VAS scores, when compared to preoperative scores. This improvement in ACFAS and VAS scores speaks to the potential use of HAA in the treatment of OCD.

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Section: Introductionmentioning

confidence: 99%

Human Amniotic Allograft in Use on Talar Dome Lesions: A Prospective Report of 37 Patients

Anderson¹,

Swayzee²,

Hansen³

2014

SCD

Self Cite

View full text Add to dashboard Cite

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“…They have applied it to calcaneal osteotomies with iliac crest grafts, trans-chondral fracture defects of the talus (TCF), tendon ruptures, high-risk fusions and high-risk wounds [24]- [26]. The authors were hopeful that the addition of HAA would improve the outcomes of the injury and assist in the ability to replace the typical fibrocartilage tissue with a greater quality hyaline cartilage [27] [28].…”

Section: Introductionmentioning

confidence: 99%

“…The authors have used amniotic allograft for other surgery applications and have so far encountered no adverse effects [24] [25]. They have applied it to calcaneal osteotomies with iliac crest grafts, trans-chondral fracture defects of the talus (TCF), tendon ruptures, high-risk fusions and high-risk wounds [24]- [26].…”

Section: Introductionmentioning

confidence: 99%

The Use of Human Amniotic Allograft on Osteochondritis Dissecans of the Talar Dome: A Comparison with and without Allografts in Arthroscopically Treated Ankles

Anderson¹,

Swayzee²

2015

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Arthroscopy of the ankle with micro-fracture technique is one way to initially treat symptomatic talar dome lesions. Human amniotic allograft has been used in similar bone, soft tissue and cartilage defects to aid in healing of tissue using graft cells that have not differentiated into a particular cell line. Patients were taken from the primary surgeon's practice to include those who had undergone arthroscopy with micro-fracture technique for treatment of a talar dome lesion less than 2 cm 2 . 101 patient surgeries were completed arthroscopically without additional major procedures. 54 surgeries were completed with human amniotic allograft; 47 were completed without (control group). Modified ACFAS ankle scores were taken pre-operatively, 3, 12 and 24 months post-operatively. Visual analog pain scores were taken pre-operatively and 24 months post-operatively. Results comparing pre-operative modified ACFAS scores between the control and graft groups were not significantly different (p = 0.14). There was a significant improvement in both groups' scores following ankle arthroscopy with micro-fracture as expected. However, the amniotic tissue group did significantly better when comparing the post-operative scores between the control and graft group. Pain scores comparing control and amniotic patient groups were significant (p < 0.001) with amniotic allograft patients achieving a greater improvement in pain reduction than the control both early and at 24 months. There were no complications, wound dehiscence or infections recorded. Combining ankle arthroscopy/micro-fracture technique with human amniotic allograft on talar dome lesions, less than 2 cm 2 , significantly improves the patients' pain and ACFAS scores.

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Initial Experience with Tricortical Iliac Crest Bone Graft and Human Amniotic Allograft in Evans Calcaneal Osteotomy

Cited by 2 publications

References 26 publications

Human Amniotic Allograft in Use on Talar Dome Lesions: A Prospective Report of 37 Patients

Human Amniotic Allograft in Use on Talar Dome Lesions: A Prospective Report of 37 Patients

The Use of Human Amniotic Allograft on Osteochondritis Dissecans of the Talar Dome: A Comparison with and without Allografts in Arthroscopically Treated Ankles

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