Shi Eric, Carter Ryan, Weinraub Glenn M
Resident Physician, Department of Podiatry, Kaiser Permanente South Bay Consortium, Kaiser Permanente Santa Clara, Santa Clara, CA.
Attending Foot and Ankle Surgeon, University Foot and Ankle Institute, Santa Monica, CA.
J Foot Ankle Surg. 2019 Jan;58(1):2-5. doi: 10.1053/j.jfas.2018.03.048. Epub 2018 Oct 10.
Foot and ankle surgeons continue to explore bone graft alternatives that will be comparable to the reference standard of autologous bone. The purpose of the present study was to consider the outcomes of hindfoot arthrodesis supplemented with bioactive glass in patients at risk of delayed union and nonunion. We performed a retrospective radiographic review of 29 consecutive patients (48 joints) who had undergone arthrodesis of ≥1 joint of the hindfoot (ankle, subtalar, talonavicular, calcaneocuboid). All patients included in the present study had a minimum of 1 documented risk factor for osseous nonunion (history of previous nonunion, trauma, smoking, diabetes, Charcot arthropathy, obesity, age >65 years at surgery). The patients were followed up for a minimum of 24 weeks or until radiographic healing had been achieved. We found 12 (25.0%) nonunions across all 48 joints supplemented with bioactive glass. We found 4 (16.7%) nonunions in the subtalar joint, 1 (11.1%) in the calcaneocuboid joint, and 1 (11.1%) in the talonavicular joint. We found that hindfoot arthrodesis procedures supplemented with bioactive glass resulted in an incidence of union comparable to that with autograft and other bone graft substitutes.
足踝外科医生继续探索与自体骨参考标准相当的骨移植替代物。本研究的目的是评估在有骨不连和延迟愈合风险的患者中，补充生物活性玻璃的后足关节融合术的疗效。我们对29例连续患者（48个关节）进行了回顾性影像学检查，这些患者均接受了至少1个后足关节（踝关节、距下关节、距舟关节、跟骰关节）的融合术。本研究纳入的所有患者均至少有1项记录在案的骨不连风险因素（既往骨不连病史、创伤、吸烟、糖尿病、夏科氏关节病、肥胖、手术时年龄>65岁）。患者至少随访24周或直至影像学显示愈合。我们发现，在所有补充生物活性玻璃的48个关节中，有12个（25.0%）发生骨不连。我们发现距下关节有4个（16.7%）骨不连，跟骰关节有1个（11.1%），距舟关节有1个（11.1%）。我们发现，补充生物活性玻璃的后足关节融合术的愈合率与自体骨移植和其他骨移植替代物相当。
