A radiographic and clinical comparison of reamer-irrigator-aspirator versus iliac crest bone graft in ankle arthrodesis.
OBJECTIVE
We evaluated radiographic fusion at follow-up and complication rates in patients who had either iliac crest (ICBG) or femoral reamer-irrigator-aspirator (RIA) bone graft for tibiotalar fusion.


METHODS
We retrospectively reviewed charts and radiographs of all patients who had a tibiotalar fusion from August 2007 to February 2011. Records were analysed for patient demographics, complications, and clinical symptoms. Radiographs were reviewed in sequential order by two fellowship-trained foot and ankle surgeons and one orthopaedic surgeon who specialises in foot and ankle surgery to determine radiographic fusion at routine follow-up. Patients were contacted to determine current visual analog scores (VAS) at their graft site.


RESULTS
Mean patient age was 49.4 ± 12.1 years in the RIA group and 49.3 ± 15.4 years in the ICBG group (p = .97). Pre-operative characteristics showed no significant differences between groups. The ICBG group had significantly more nonunions than the RIA group (six vs. one, p = 0.04). Two patients in the ICBG had chronic pain at their graft site based on their VAS score; there were none in the RIA group. Radiographic fusion at follow-up was similar between groups, with no significant difference (12.48 ± 3.85 weeks vs.12.21 ± 3.19 weeks, p = .80).


CONCLUSIONS
There was a significantly higher nonunion rate in the ICBG group, but both groups had a solid radiographic bony fusion at similar follow-up time points. Our results suggest RIA bone graft is a viable alternative to ICBG for tibiotalar fusion.
Department of Orthopedics, University at Buffalo, 462 Grider Street, Buffalo, NY, 14215, USA, Spodzo@gmail.com.
Scott R
SR
Nodzo
Nathan B
NB
Kaplan
Donald W
DW
Hohman
Christopher A
CA
Ritter
D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013628:Talus / Q000000981:diagnostic imaging / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery