Park Young Uk, Cho Jae Ho, Kim Taehun, Cho Won-Tae, Jun Jinyoung, Seo Young Wook
Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon 16499, Gyeonggi-do, Republic of Korea.
J Clin Med. 2025 Apr 14;14(8):2683. doi: 10.3390/jcm14082683.
: Tibiotalocalcaneal (TTC) arthrodesis using talar allografts has emerged as a viable surgical option for managing complex hindfoot pathologies, including post-traumatic avascular necrosis (AVN), infection-related complications, and failed total ankle replacement (TAR). These conditions present significant therapeutic challenges due to extensive bone loss and joint instability. Previous reports have focused on TTC arthrodesis using talar allografts, highlighting its potential to provide enhanced structural support. This study aims to further evaluate the efficacy and safety of this surgical approach by assessing union, clinical outcomes, and complications in a diverse patient population. : This retrospective study reviewed 11 patients who underwent TTC arthrodesis with talar allograft between January 2020 and November 2022. The study cohort included patients with post-traumatic AVN, infection-related complications, and failed TAR. Preoperative and postoperative evaluations included X-rays, computed tomography scans, and functional outcome scores such as the Visual Analog Scale (VAS) and the Foot and Ankle Outcome Score (FAOS). : This study included 11 patients who underwent surgical treatment between January 2020 and November 2022, with a minimum follow-up of 24 months and a mean follow-up of 33.45 months (range, 24-50 months). Successful arthrodesis was observed in nine patients, yielding a success rate of 82%. Significant improvements in functional outcomes were noted, including marked reductions in pain and enhanced activity levels, as evaluated by VAS and FAOS scores. Two patients demonstrated radiographic nonunion (one tibiotalar, one subtalar), but both remained asymptomatic and did not require revision surgery. No other complications such as infection, wound issues, or thromboembolism were observed. Immediate postoperative radiographs confirmed appropriate allograft alignment and placement. : TTC arthrodesis using structural talar allografts may be a viable and safe option for managing severe hindfoot pathology, potentially resulting in satisfactory fusion rates and clinical outcomes.
使用距骨同种异体骨进行胫距跟（TTC）关节融合术已成为治疗复杂后足病变的一种可行手术选择，这些病变包括创伤后缺血性坏死（AVN）、感染相关并发症以及全踝关节置换（TAR）失败。由于广泛的骨质流失和关节不稳定，这些情况带来了重大的治疗挑战。先前的报告集中在使用距骨同种异体骨的TTC关节融合术，强调其提供增强结构支撑的潜力。本研究旨在通过评估不同患者群体的融合情况、临床结果和并发症，进一步评估这种手术方法的疗效和安全性。
这项回顾性研究对2020年1月至2022年11月期间接受距骨同种异体骨TTC关节融合术的11例患者进行了回顾。研究队列包括创伤后AVN、感染相关并发症和TAR失败的患者。术前和术后评估包括X线、计算机断层扫描以及功能结果评分，如视觉模拟量表（VAS）和足踝结果评分（FAOS）。
本研究纳入了2020年1月至2022年11月期间接受手术治疗的11例患者，最小随访时间为24个月，平均随访时间为33.45个月（范围为24 - 50个月）。9例患者实现了成功融合，成功率为82%。根据VAS和FAOS评分评估，功能结果有显著改善，包括疼痛明显减轻和活动水平提高。2例患者出现影像学骨不连（1例胫距关节，1例距下关节），但均无症状，无需翻修手术。未观察到其他并发症，如感染、伤口问题或血栓栓塞。术后即刻X线片证实同种异体骨排列和放置合适。
使用结构性距骨同种异体骨进行TTC关节融合术可能是治疗严重后足病变的一种可行且安全的选择，可能会带来令人满意的融合率和临床结果。
