Treatment of Post-traumatic Ankle Arthrosis with Bipolar Tibiotalar Osteochondral Shell Allografts

We report on tibiotalar osteochondral shell allografts for post-traumatic ankle arthropathy in seven patients. Average follow-up was 148 months (range, 85 to 198). Patients were evaluated by a questionnaire, SF-12 survey, ankle score, physical exam and radiographs. The ankle score increased from 25...

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Bibliographic Details
Published in:Foot & ankle international 2002-12, Vol.23 (12), p.1091-1102
Main Authors: Kim, Choll W., Jamali, Amir, Tontz, William, Convery, F. Richard, Brage, Michael E., Bugbee, William
Format: Article
Language:English
Subjects:
Adult
Aged
Ankle Injuries - complications
Ankle Joint - surgery
Bone Transplantation - adverse effects
Cadaver
Cartilage, Articular - transplantation
Female
Follow-Up Studies
Humans
Joint Diseases - etiology
Joint Diseases - surgery
Male
Middle Aged
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Summary:We report on tibiotalar osteochondral shell allografts for post-traumatic ankle arthropathy in seven patients. Average follow-up was 148 months (range, 85 to 198). Patients were evaluated by a questionnaire, SF-12 survey, ankle score, physical exam and radiographs. The ankle score increased from 25 preoperatively to 43 at latest follow-up (maximum score 100). SF-12 scores increased from 30 to 38 (Physical Component) and 46 to 53 (Mental Component). The failure rate was 42%. Four of seven patients reported good or excellent results. Five patients stated they would undergo a similar procedure again. Complications included graft fragmentation, poor graft fit, graft subluxation, and non-union. Follow-up radiographs demonstrated joint space narrowing, osteophytes, and sclerosis, even in cases with excellent clinical status. Fresh osteochondral shell allografting may provide a viable alternative for the treatment of post-traumatic ankle arthrosis in selected individuals.
ISSN:1071-1007
1944-7876
DOI:10.1177/107110070202301203