title: Treatment of post-traumatic ankle arthrosis with bipolar tibiotalar osteochondral shell allografts.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Diego, CA, USA.
authors.forename: Choll W
authors.initials: CW
authors.lastname: Kim
authors.forename: Amir
authors.initials: A
authors.lastname: Jamali
authors.forename: William
authors.initials: W
authors.lastname: Tontz
authors.forename: F Richard
authors.initials: FR
authors.lastname: Convery
authors.forename: Michael E
authors.initials: ME
authors.lastname: Brage
authors.forename: William
authors.initials: W
authors.lastname: Bugbee
mesh_terms: D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000150:complications; D000843:Ankle Joint / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects; D002102:Cadaver; D002358:Cartilage, Articular / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged