title: Femoral head allograft for tibiotalocalcaneal fusion using a cup and cone reamer technique.
abstract: End-stage degenerative joint disease of the hindfoot with large structural bone deficits is a complex problem encountered by the foot and ankle surgeon. Surgical treatment of this condition often requires tibiotalocalcaneal fusion with use of structural allograft bone. In this article, we describe a technique in which an acetabular reamer is used to create a concave surface for placement of a convex femoral head allograft. This "cup-and-cone" technique provides a congruent area for placement of the allograft, thereby increasing stability of the graft during preparation and placement of an intramedullary nail, while maximizing bone-to-bone surface contact at the arthrodesis site.
authors.affiliation: Orthopedic Foot & Ankle Center, Westerville, OH 43082, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cuttica
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Hyer
mesh_terms: D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D002111:Calcaneus / Q000601:surgery; D005270:Femur Head / Q000601:surgery; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D016268:Internal Fixators; D010003:Osteoarthritis / Q000150:complications / Q000601:surgery; D012680:Sensitivity and Specificity; D013977:Tibia / Q000601:surgery; D014184:Transplantation, Homologous; D016896:Treatment Outcome