Background: Osteochondral allograft (OCA) transplantation is a useful treatment for posttraumatic ankle arthritis
in young patients, but failure rates are high and reoperations are not uncommon. The aim of this study was to
evaluate the outcomes of failed ankle OCA transplantation converted to ankle arthrodesis (AA) or total ankle
arthroplasty (TAA).
Methods: We evaluated 24 patients who underwent salvage procedures (13 AA and 11 TAA) after primary failed ankle
OCA transplantation. Reoperations were assessed. Failure of the salvage procedure was defined as an additional surgery
that required a revision AA/TAA or amputation. Evaluation among nonfailing ankles included the American Academy of
Orthopaedic Surgeons Foot and Ankle Module (AAOS-FAM), pain, and satisfaction.
Results: In the salvage AA cohort, 3 patients were classified as failures (2 revision AA and 1 amputation). The 10 nonfailing
patients had a mean follow-up of 7.4 years. Eighty-eight percent were satisfied with the procedure, but 63% reported
continued problems with their ankle (eg, pain, swelling, stiffness). Mean pain level was 1.9 and AAOS-FAM core score was
83±13. In the salvage TAA cohort, 2 patients were classified as failures (both revision TAA). The 9 nonfailing patients had
a mean follow-up of 3.8 years. Fifty percent were satisfied with the procedure, but 40% reported continued problems with
their ankle. The mean pain level was 1.3, and the median AAOS-FAM core score was 82±26.
Conclusion: Revision and reoperation rates for salvage procedures following failed OCA transplantation of the ankle are
higher compared to published data for primary AA and TAA procedures. However, we believe OCA transplantation can
serve as an interim procedure for younger patients with advanced ankle joint disease who may not be ideal candidates for
primary AA or TAA at the time of initial presentation.
Level of Evidence: Level IV, case series.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:80561 |
| Date | 02 September 2022 |
| Creators | Gaul, Florian, Barr, Cameron R., McCauley, Julie C., Copp, Steven N., Bugbee, William D. |
| Publisher | SAGE Publications |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
Page generated in 0.0018 seconds