Isolated talocalcaneal arthrodesis. A technique using moldable bone graft.

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Bone Grafting Techniques

Background:

• Talocalcaneal joint arthritis significantly impacts patient mobility and quality of life.
• Surgical fusion (arthrodesis) is a common treatment for severe talocalcaneal joint arthritis.
• Effective surgical techniques are crucial for successful talocalcaneal joint fusion.

Purpose of the Study:

• To evaluate the efficacy of combined autogenous iliac-crest bone grafting and internal fixation for talocalcaneal joint fusion.
• To assess patient satisfaction and objective outcomes following this surgical procedure.
• To determine the incidence of complications and secondary degenerative changes after talocalcaneal arthrodesis.

Main Methods:

• Forty-one adult patients (45 arthrodeses) underwent talocalcaneal joint fusion using autogenous iliac-crest bone graft and pin/screw fixation.
• Patients were followed for a mean of 57 months (range, 30-96 months).
• Outcomes were assessed through patient satisfaction, objective clinical evaluation, and radiographic examination.

Main Results:

• 90% of patients reported satisfaction with the surgical outcome.
• 87% of arthrodeses showed excellent objective results, with 11% good/fair and 2% poor.
• One case of non-union and one superficial wound infection were reported; no secondary degenerative changes were observed radiographically.

Conclusions:

• Combined autogenous iliac-crest bone grafting and internal fixation is an effective surgical technique for talocalcaneal joint fusion in adults.
• The procedure demonstrates high rates of patient satisfaction and favorable objective outcomes.
• This method appears safe, with a low complication rate and no evidence of adjacent joint degeneration post-surgery.