Allograft Cellular Bone Matrix as an Alternative to Autograft in Hindfoot and Ankle Fusion Procedures
Allograft Cellular Bone Matrix as an Alternative to Autograft in Hindfoot and Ankle Fusion Procedures
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DOI：
10.1053/j.jfas.2011.10.001
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发表时间：
2012-03-01
影响因子：
1.3
通讯作者：
Hollawell, Shane M.
中科院分区：
文献类型：
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作者：
Hollawell, Shane M.
本报告总结了Osteocel Plus在单中心20例后足和踝关节融合中的影像学结果。患者人群中40%为女性，平均年龄为57.9 ± 16.1岁。平均体重指数为33.8 +/- 9.1。危险因素包括3名吸烟者和6名糖尿病患者。主要手术适应症包括创伤（50%）、Charcot关节病（15%）、足下垂伴骨关节炎（20%）、原发性骨关节炎（10%）和全距骨挤压（5%）。9例患者有同足后足手术史;然而，该系列中报告的病例中只有2例是由于既往手术失败而进行的翻修;其余7例接受了创伤性畸形矫正（n=5）或同足新部位诊断（n=2）。治疗包括距下关节融合术（50%）、踝关节融合术（40%）、三重融合术（5%）和胫骨-跟骨-跟骨-骰骨关节融合术（5%）。6个月评价时，在100%的患者中观察到牢固融合。平均融合时间为13.5周。尽管既往接受过手术的患者的融合时间倾向于长于首次接受后足和踝关节手术的患者（14.4 +/- 5.3 vs. 12.6 +/- 5.7周），但差异无统计学显著性（p= 0.47）。没有移植物排斥或失败的证据。该系列研究表明，基于间充质干细胞的同种异体骨是一种安全有效的骨愈合材料，在足和踝关节融合术中具有较高的影像学成功率，融合率成功且及时。(C)2012年由美国足踝外科医师学会（American College of Foot and Ankle Surgeons）All rights reserved.
This report summarizes the radiographic results of Osteocel Plus in 20 hindfoot and ankle fusions at a single center. The patient population was 40% female with an average age of 57.9 +/- 16.1 years. Average body mass index was 33.8 +/- 9.1. Risk factors included 3 smokers and 6 patients with diabetes. Primary surgical indications included trauma (50%), Charcot arthropathy (15%), foot drop with osteoarthritis (20%), primary osteoarthritis (10%), and total talar extrusion (5%). Nine patients had a history of prior hindfoot surgery in the same foot; however, only 2 of the cases reported in this series were revisions due to a failed prior surgery; the remaining 7 were treated for correction of a traumatic deformity (n=5) or diagnosis at a new site in the same foot (n=2). Treatment included subtalar joint arthrodesis (50%), ankle arthrodesis (40%), triple fusion (5%), and tibial-calcaneal-calcaneal-cuboid arthrodesis (5%). Solid fusion was observed in 100% of patients by the 6-month evaluation. Average time to fusion was 13.5 weeks. Although patients with a prior surgery trended toward a longer time to fusion than patients who underwent their first hindfoot and ankle procedure (14.4 +/- 5.3 vs. 12.6 +/- 5.7 weeks), the difference was not statistically significant (p=.47). There was no evidence of graft rejection or failure. This series demonstrates that mesenchymal stem cell-based bone allograft is a safe and effective bone-healing material with a high radiographic success rate in foot and ankle arthrodeses with successful and timely fusion rates. (C) 2012 by the American College of Foot and Ankle Surgeons. All rights reserved.