title: Evidence-Based Rationale for Ankle Cartilage Allograft Replacement: A Systematic Review of Clinical Outcomes.
abstract: The treatment of ankle arthritis remains controversial. Ankle cartilage allograft replacement is a novel and complex procedure. Many clinical studies have shown some level of promise, as well complications. We performed a systematic review of the clinical outcomes to describe and assess the different techniques and clinical outcomes for ankle cartilage allograft replacement. We performed a review of the published studies using MEDLINE(®) by way of PubMed(®) and Google Scholar(®) from January 2000 through October 2014, ranging from case reports to clinical studies. The inclusion criteria consisted of ankle cartilage allograft procedures with objective findings and clinical outcome scoring and complication and fusion rates and excluded nonallograft synthetic graft techniques, bone substitutes or expanders, review reports, and technique instructional manuals. Evidence with the combination of objective findings and clinical outcomes for all 3 type of allograft replacement (osteochondral, unipolar, and bipolar) is lacking. Several techniques for cartilage fixation have been described, including absorbable and metallic fixation. Most of the studies reported many occurrences and a variety of complications. A myriad of techniques for ankle cartilage allograft replacement exists. The results from the present systematic review of the published studies appear promising; however, the lack of statistical power and inconsistent documentation made it difficult to determine the superiority of any one intervention compared with another for the treatment of ankle arthritis.
authors.affiliation: Undergraduate Medical Education, Drexel University College of Medicine, Sacramento, CA.
authors.forename: Pierce
authors.initials: P
authors.lastname: Johnson
authors.affiliation: Undergraduate Medical Education, Drexel University College of Medicine, Sacramento, CA; Assistant Director, Undergraduate and Graduate Medical Education, Kaiser Permanente South Sacramento Medical Center, South Sacramento, CA. Electronic address: dkleesd@yahoo.com.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Lee
mesh_terms: D064591:Allografts; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D002356:Cartilage / Q000637:transplantation*; D019317:Evidence-Based Medicine; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012720:Severity of Illness Index; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
keywords: ankle; arthritis; cartilage; replacement