title: Ankle arthrodesis fusion rates for mesenchymal stem cell bone allograft versus proximal tibia autograft.
abstract: Ankle arthrodesis is commonly used in the treatment of ankle arthritis. The present study compared mesenchymal stem cell (MSC) bone allografts and proximal tibia autografts as adjuncts in performing ankle arthrodesis. A total of 109 consecutive ankle fusions performed from 2002 to 2008 were evaluated retrospectively. Of the 109 fusions, 24 were excluded from the present study, leaving 85 patients who had undergone ankle arthrodesis. Of the 85 patients, 41 had received a proximal tibia autograft and 44, an MSC bone allograft. These 2 groups were reviewed and compared retrospectively at least 2 years postoperatively for the overall fusion rate, interval to radiographic fusion, and interval to clinical fusion. A modified and adjusted American College of Foot and Ankle Surgeons ankle scale was used to measure patient satisfaction. The overall fusion rate was 84.1% in the MSC bone allograft group and 95.1% in the proximal tibia autograft group (p = .158). The corresponding mean intervals to radiographic fusion were 13.0 ± 2.5 weeks and 11.3 ± 2.8 weeks (p ≤ .001). The interval to clinical fusion was 13.1 ± 2.1 weeks and 11.0 ± 1.5 weeks (p ≤ .001) in the MSC bone allograft and proximal tibia autograft group, respectively. No statistically significant difference was found in the fusion rates between the MSC bone allograft and proximal tibia autograft groups. Also, no statistically significant difference was found between the preoperative and postoperative scores using a modified and adjusted American College of Foot and Ankle Surgeons ankle scale between the 2 groups (p = .41 and p = .44, respectively). A statistically significant delay to radiographic and clinical fusion was present in the MSC bone allograft group compared with the proximal tibia autograft group; however, no difference was found in patient satisfaction.
authors.affiliation: New Mexico Bone and Joint Institute, Alamogordo, NM.
authors.forename: John J
authors.initials: JJ
authors.lastname: Anderson
authors.affiliation: Scripps Mercy-Kaiser San Diego Residency Program, San Diego, CA.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Boone
authors.affiliation: Cactus Foot and Ankle, Chandler, AZ.
authors.forename: Myron
authors.initials: M
authors.lastname: Hansen
authors.affiliation: New Mexico Foot and Ankle Institute, Albuquerque, NM.
authors.forename: Chad
authors.initials: C
authors.lastname: Brady
authors.affiliation: Gila Regional Medical Center, Silver City, NM.
authors.forename: Adam
authors.initials: A
authors.lastname: Gough
authors.affiliation: New Mexico Bone and Joint Institute, Alamogordo, NM. Electronic address: zflanf@gmail.com.
authors.forename: Zflan
authors.initials: Z
authors.lastname: Swayzee
mesh_terms: D000368:Aged; D064591:Allografts; D000843:Ankle Joint / Q000601:surgery*; D001168:Arthritis / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D064592:Autografts; D016025:Bone Transplantation; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation; D008875:Middle Aged; D012189:Retrospective Studies; D013977:Tibia / Q000637:transplantation*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
keywords: ACFAS ankle score; ankle arthritis; ankle fusion; autograft; bone graft; mesenchymal stem cell (MSC)