Role of cellular allograft containing mesenchymal stem cells in high-risk foot and ankle reconstructions

The use of cellular allograft containing mesenchymal stem cells is gaining popularity as an augmentation to foot and ankle arthrodesis. Those with underlying comorbidities (diabetes mellitus, Charcot osteoarthropathy, smoking, suppressive medication, increased body mass index) are more likely to require surgical revision procedures and typically have a greater rate of nonunion than their healthy counterparts. We believe that the use of a mesenchymal stem cell graft will increase the likelihood of a successful fusion during the primary procedure. The present study reviewed the use of stem cell grafting in hindfoot and ankle surgery and the healing times in high-risk patients. Successful fusion was defined as bridging across 3 cortices. In this patient group, the average interval to radiologic union was 11.1 ± 2.0 (range 8 to 15) weeks. The interval to partial weightbearing was 5.5 ± 1.8 (range 3 to 12) weeks, to full weightbearing was 8.4 ± 1.9 (range 5 to 14) weeks, and to shoe wearing was 13.6 ± 3.0 (range 10 to 20) weeks.