Medical University of Vienna, Austria.
Orthopedic Departement Klinik Diakonissen Linz, Linz, Austria.
Foot Ankle Int. 2022 Jul;43(7):913-922. doi: 10.1177/10711007221081533. Epub 2022 Apr 2.
For arthrodesis of the tarsometatarsal joints, there is the possibility of using a transplant screw made of allogenic human bone material (Shark Screw). This article investigates the clinical outcome and radiologic integration of the allogenic bone screw for arthrodesis of the tarsometatarsal joints II/+III.
This is a prospective study involving 20 feet of 17 patients who received TMT II/+III arthrodesis with an allogenic bone screw. A visual analog scale (VAS pain and function), Foot Function Index (FFI), American Orthopaedic Foot & Ankle Society (AOFAS) midfoot score, and Foot and Ankle Outcome Score (FAOS) were used as measures to compare preoperative with postoperative results. Radiologic integration in the recipient bone was also evaluated.
A significant mean pre- to postoperative improvement of all evaluated scores has been observed ( < .05) after a mean follow-up of 15.87 months (minimum 12 months, maximum 33 months). VAS score (pain) decreased from 7.6 to 1.4 points as well as a decrease of the VAS (function) from 7.25 to 1.8 points. Further, a reduction of the FFI from 62.3% to 16.7% and an increase from 29.7 to 79.9 points of the AOFAS was detected. Analyzing the FAOS score, in all surveyed subscales, there was an increase in the score (Symptoms: 55.2 to 85.6 points; Pain: 30.5 to 86.9 points; Function: 33.1 to 88.3 points; Quality of life: 27.8 to 79.7 points). Moreover, in all cases, a complete radiologic integration into the receiving bone was appreciated, and after a minimum follow-up time from 12 months, the screw in 19 feet (95%) was no longer distinguishable from the original bone.
With these first results of the allogenic bone screw in TMT II/+III arthrodesis, a significant improvement from preoperative to postoperative was confirmed in the collected scores, and a full radiographic integration was demonstrated in all feet.
对于跗跖关节融合术，有可能使用同种异体人骨材料制成的移植螺钉（Shark Screw）。本文研究了同种异体骨螺钉用于跗跖关节 II/+III 融合的临床结果和放射学整合。
这是一项前瞻性研究，共涉及 17 名患者的 20 只脚，这些患者接受了 TMT II/+III 融合术，使用同种异体骨螺钉。视觉模拟评分（VAS 疼痛和功能）、足功能指数（FFI）、美国矫形足踝协会（AOFAS）中足评分和足踝结局评分（FAOS）用于比较术前和术后结果。还评估了同种异体骨在受者骨中的整合情况。
在平均随访 15.87 个月（最短 12 个月，最长 33 个月）后，所有评估的评分均有显著的术前到术后改善（ <.05）。VAS 评分（疼痛）从 7.6 分降至 1.4 分，VAS（功能）从 7.25 分降至 1.8 分。此外，FFI 从 62.3%降至 16.7%，AOFAS 从 29.7 分增至 79.9 分。分析 FAOS 评分，在所有调查的子量表中，评分均有所增加（症状：55.2 至 85.6 分；疼痛：30.5 至 86.9 分；功能：33.1 至 88.3 分；生活质量：27.8 至 79.7 分）。此外，在所有病例中，均观察到同种异体骨在受区骨中的完全放射学整合，在 12 个月的最短随访时间后，19 只脚（95%）中的螺钉已无法与原始骨区分。
根据 TMT II/+III 融合术同种异体骨螺钉的这些初步结果，证实了收集的评分从术前到术后有显著改善，并且所有足部均显示出完全的放射学整合。
