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Isolated talocalcaneal arthrodesis. A technique using moldable bone graft.

G M Russotti1, J R Cass, K A Johnson

  • 1Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.

The Journal of Bone and Joint Surgery. American Volume
|December 1, 1988
PubMed
Summary

This study shows that combining bone grafting with internal fixation effectively fuses the talocalcaneal joint in adults, leading to high patient satisfaction and good clinical outcomes for arthritis treatment.

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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.

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  • 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.