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Subtalar distraction arthrodesis using interpositional frozen structural allograft.

Publication ,  Journal Article
Garras, DN; Santangelo, JR; Wang, DW; Easley, ME
Published in: Foot Ankle Int
June 2008

BACKGROUND: Subtalar bone-block distraction arthrodesis using structural autograft carries the risk of donor site morbidity. Recent reports suggest that structural allograft may be an attractive alternative to structural autograft in subtalar arthrodesis. This prospective study analyzes subtalar distraction arthrodesis using interpositional structural allograft. MATERIALS AND METHODS: Between 2000 and 2006, 22 patients (24 feet; mean age, 45.6 years) underwent subtalar arthrodesis with interpositional fresh-frozen femoral head structural allograft. Indications included subtalar arthrosis, loss of heel height, and anterior ankle impingement. Clinical outcome was assessed using the AOFAS ankle-hindfoot scoring system. Time to union was determined by previously reported clinical findings and radiographic evidence for bridging trabeculation between host bone and structural allograft. RESULTS: Mean followup was 35.8 months for 20 patients (21 feet) available for followup evaluation. Union was achieved in 19 of 21 patients (90%) at a mean of 15.5 (range, 11 to 19) weeks. Mean AOFAS hindfoot score improved from 21 to 71 points (p < 0.05). Radiographic analysis suggested significant (p < 0.05) improvement in all measurements. Complications included nonunion (2), varus malalignment (1), persistent subfibular impingement (1), sural neuralgia (1), and prominent hardware (2). Both patients with nonunions had avascular bone at the arthrodesis site and used tobacco products. CONCLUSION: This study supports recent publications that subtalar arthrodesis using interpositional structural allograft can have a favorable outcome. Our clinical and radiographic results suggest that restoration of hindfoot function and dimensions with structural allograft are comparable to results reported for the same procedure using structural autograft. LEVEL OF EVIDENCE: Level IV, prospective case series.

Duke Scholars

Published In

Foot Ankle Int

DOI

ISSN

1071-1007

Publication Date

June 2008

Volume

29

Issue

6

Start / End Page

561 / 567

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Subtalar Joint
  • Prospective Studies
  • Osteogenesis, Distraction
  • Orthopedics
  • Middle Aged
  • Male
  • Joint Diseases
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Garras, D. N., Santangelo, J. R., Wang, D. W., & Easley, M. E. (2008). Subtalar distraction arthrodesis using interpositional frozen structural allograft. Foot Ankle Int, 29(6), 561–567. https://doi.org/10.3113/FAI.2008.0561
Garras, David N., James R. Santangelo, David W. Wang, and Mark E. Easley. “Subtalar distraction arthrodesis using interpositional frozen structural allograft.Foot Ankle Int 29, no. 6 (June 2008): 561–67. https://doi.org/10.3113/FAI.2008.0561.
Garras DN, Santangelo JR, Wang DW, Easley ME. Subtalar distraction arthrodesis using interpositional frozen structural allograft. Foot Ankle Int. 2008 Jun;29(6):561–7.
Garras, David N., et al. “Subtalar distraction arthrodesis using interpositional frozen structural allograft.Foot Ankle Int, vol. 29, no. 6, June 2008, pp. 561–67. Pubmed, doi:10.3113/FAI.2008.0561.
Garras DN, Santangelo JR, Wang DW, Easley ME. Subtalar distraction arthrodesis using interpositional frozen structural allograft. Foot Ankle Int. 2008 Jun;29(6):561–567.
Journal cover image

Published In

Foot Ankle Int

DOI

ISSN

1071-1007

Publication Date

June 2008

Volume

29

Issue

6

Start / End Page

561 / 567

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Subtalar Joint
  • Prospective Studies
  • Osteogenesis, Distraction
  • Orthopedics
  • Middle Aged
  • Male
  • Joint Diseases
  • Humans