title: Functional evaluation of patients treated with osteochondral allograft transplantation for post-traumatic ankle arthritis: one year follow-up.
abstract: Severe post-traumatic ankle arthritis poses a reconstructive challenge in active patients. Whereas traditional surgical treatments, i.e. arthrodesis and arthroplasty, provide good pain relief, arthrodesis is associated to functional and psychological limitations, and arthroplasty is prone to failure in the active patient. More recently the use of bipolar fresh osteochondral allografts transplantation has been proposed as a promising alternative to the traditional treatments. Preliminary short- and long-term clinical outcomes for this procedure have been reported, but no functional evaluations have been performed to date. The clinical and functional outcomes of a series of 10 patients who underwent allograft transplantation at a mean follow-up of 14 months are reported. Clinical evaluation was performed with the AOFAS score, functional assessment by state-of-the-art gait analysis. The clinical score significantly improved from a median of 54 (range 12-65) pre-op to 76.5 (range 61-86) post-op (p=0.002). No significant changes were observed for the spatial-temporal parameters, but motion at the hip and knee joints during early stance, and the range of motion of the ankle joint in the frontal plane (control: 13.8°±2.9°; pre-op: 10.4°±3.1°, post-op: 12.9°±4.2°; p=0.02) showed significant improvements. EMG signals revealed a good recovery in activation of the biceps femoris. This study showed that osteochondral allograft transplantation improves gait patterns. Although re-evaluation at longer follow-ups is required, this technique may represent the right choice for patients who want to delay the need for more invasive joint reconstruction procedures.
authors.affiliation: Movement Analysis Laboratory, Istituto Ortopedico Rizzoli, Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Berti
authors.forename: F
authors.initials: F
authors.lastname: Vannini
authors.forename: G
authors.initials: G
authors.lastname: Lullini
authors.forename: P
authors.initials: P
authors.lastname: Caravaggi
authors.forename: A
authors.initials: A
authors.lastname: Leardini
authors.forename: S
authors.initials: S
authors.lastname: Giannini
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000150:complications; D000843:Ankle Joint / Q000601:surgery*; D001168:Arthritis / Q000209:etiology / Q000601:surgery*; D001696:Biomechanical Phenomena; D016025:Bone Transplantation / Q000379:methods*; D002356:Cartilage / Q000637:transplantation*; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous; D016896:Treatment Outcome
keywords: Allograft transplantation; Ankle arthritis; EMG; Functional evaluation; Gait analysis