title: Arthrodesis of the ankle using an anterior sliding tibial graft for osteoarthritis secondary to osteonecrosis of the talus: A comparison of vascularised non-vascularised grafts.
abstract: OBJECTIVE
  This retrospective cohort study compared the results of vascularised and non-vascularised anterior sliding tibial grafts for the treatment of osteoarthritis (OA)of the ankle secondary to osteonecrosis of the talus.
  
  
  METHODS
  We reviewed the clinical and radiological outcomes of 27 patients who underwent arthrodesis with either vascularised or non-vascularised (conventional) grafts, comparing the outcomes (clinical scores, proportion with successful union and time to union) between the two groups. The clinical outcome was assessed using the Mazur and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores. The mean follow-up was 35 months (24 to 68).
  
  
  RESULTS
  The mean outcome scores increased significantly in both groups. In the vascularised graft group, the mean Mazur score improved from 36.9 to 74.6 and the mean AOFAS scale improved from 49.6 to 80.1. In the conventional arthrodesis group, the mean Mazur score improved from 35.5 to 65 and the mean AOFAS scale from 49.2 to 67.6. Complete fusion was achieved in 13 patients (76%) in the vascularised group, but only four (40%) in the conventional group. The clinical outcomes and proportion achieving union were significantly better in the vascularised group compared with the conventional arthrodesis group, although time to union was similar in the two groups.
  
  
  CONCLUSIONS
  Vascularised sliding tibial grafts may be used to achieve arthrodesis in patients with OA of the ankle secondary to osteonecrosis of the talus.
authors.affiliation: Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kodama
authors.affiliation: Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Takemura
authors.affiliation: Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Shioji
authors.affiliation: Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Imai
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010020:Osteonecrosis / Q000150:complications*; D011182:Postoperative Care / Q000379:methods; D012039:Regional Blood Flow; D012189:Retrospective Studies; D013628:Talus / Q000000981:diagnostic imaging / Q000473:pathology; D013977:Tibia / Q000098:blood supply / Q000637:transplantation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: ankle arthrodesis; avascular necrosis of the talus; secondary osteoarthritis; vascularised bone graft