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Locally generated bone slurry accelerated ankle arthrodesis
Jacynda Wheeler1, Adam Sangeorzan, Sarah M Crass
1Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, Rehabilitation Research and Development, Department of veterans Affairs Medical Center, Seattle, WA, 98108, USA. jacyndawheeler@gmail.com
Background:
Reported ankle fusion healing times vary between 7 to 72 weeks. High non-union and delayed union rates have led to an increased use of bone graft and bone graft substitutes. It was our goal to see if addition of a bone slurry could accelerate the rate of healing.
Materials And Methods:
We compared the radiographic healing after ankle arthrodesis in two groups of patients treated over 3 years with and without a 'bone slurry.' In group one, a slurry of bone particles was generated with a low-speed burr and left in the joint before internal fixation. Group two had similar fixation but no bone slurry. Two reviewers, blinded to the presence or absence of slurry, studied magnified digital radiographs at 6 and 12 weeks. The percentage of the joint bridged by bone was recorded for each and the groups were averaged. Groups were compared using Wilcoxon rank sum.
Results:
There were 32 patients in group one and 22 in group two. Groups were similar in age, gender and diagnosis. At 6 weeks, group one had 94.1% bridging bone, as measured on AP radiographs. Group two had 76.4% bridging bone. (Wilcoxon rank sum test p = 0.0099). At 12 weeks, group one had 98.1% bridging bone and group two had 85.7% bridging bone (Wilcoxon rank sum test p = 0.026).
Conclusion:
Use of a low-speed burr to generate a "bone paste'' from the local bone surfaces was associated with an increased percentage of healed bone surface at 6 and 12 weeks in patients undergoing ankle arthrodesis.
