Midterm Results of Radiographic and Functional Outcomes After Tibiotalocalcaneal Arthrodesis With Bulk Femoral Head Allograft

IF 1.8 Q2 ORTHOPEDICS Foot and Ankle Specialist Pub Date : 2020-08-01 DOI:10.1177/1938640019863260
Ryan G. Rogero, Justin Tsai, Daniel J. Fuchs, Rachel J Shakked, S. Raikin
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引用次数: 14

Abstract

Background: Tibiotalocalcaneal (TTC) arthrodesis implementing adjunctive allografts is a method of limb salvage for patients with complex hindfoot osseous deficits, though outcome results are limited. The purposes of this study were to assess functional and radiographic outcomes after TTC arthrodesis with femoral head allograft and retrospectively identify prognostic factors. Methods: The authors reviewed 24 TTC arthrodesis procedures with bulk femoral head allografts performed by a single surgeon from 2004 to 2016. Radiographic union at the ankle and subtalar joints along with stability of the allograft were assessed. Patients who had clinically successful arthrodeses were contacted to score the Foot and Ankle Ability Measure—Activities of Daily Living (FAAM-ADL) questionnaire, Visual Analog Scale (VAS) for pain, and Short Form-12 (SF-12) at a mean of 58.0 months (range, 28-102) postoperatively. Results: Complete radiographic union of involved joints was achieved in 15 patients (63%) and in 75% (36/48) of all joints; 21 ankles (88%) were assessed to be radiographically stable at final follow-up. Three patients (13%) underwent revision arthrodesis at a mean of 18.9 months postoperatively, and 21 patients (88%) did not require additional surgery as of final follow-up. Patients significantly improved to a mean FAAM-ADL score of 71.5 from 36.3 (P < .001). The mean VAS for pain significantly improved from 77.2 to 32.9 (P < .001). Male sex (P = .08) and a lateral operative approach (P = .03) both resulted in worse outcomes. Conclusion: Use of a femoral head allograft with TTC arthrodesis can offer improved functional scores and sustained radiographic outcomes. Level of Evidence: Level IV: Case series
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大块同种异体股骨头胫骨距跟关节融合术后影像学和功能预后的中期结果
背景:胫距跟骨(TTC)关节融合术实施辅助同种异体移植物是一种修复复杂后足骨缺损患者肢体的方法,尽管结果有限。本研究的目的是评估同种异体股骨头TTC关节融合术后的功能和影像学结果,并回顾性地确定预后因素。方法:作者回顾了2004年至2016年同一外科医生进行的24例大块同种异体股骨头移植TTC关节融合术。评估了踝关节和距下关节的x线片愈合以及同种异体移植物的稳定性。在术后平均58.0个月(范围28-102),联系临床成功的关节融换术患者,对足踝能力测量-日常生活活动(FAAM-ADL)问卷、疼痛视觉模拟量表(VAS)和短表-12 (SF-12)进行评分。结果:15例(63%)受累关节的x线完全愈合,75%(36/48)的关节愈合;在最后的随访中,21个踝关节(88%)被评估为放射稳定。3例患者(13%)在术后平均18.9个月接受了翻修性关节融合术,21例患者(88%)在最后随访时不需要额外的手术。患者的平均FAAM-ADL评分从36.3分显著改善至71.5分(P < 0.001)。疼痛VAS评分从77.2分提高到32.9分(P < 0.001)。男性(P = .08)和外侧入路(P = .03)均导致较差的预后。结论:使用同种异体股骨头与TTC关节融合术可以改善功能评分和持续的影像学结果。证据等级:四级:案例系列
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来源期刊
Foot and Ankle Specialist
Foot and Ankle Specialist Health Professions-Podiatry
CiteScore
3.10
自引率
0.00%
发文量
100
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