Femoral Head Allografts for Talar Body Defects

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Bone Grafting

Background:

• Large bone deficits in the ankle, often from failed total ankle arthroplasty or talar avascular necrosis (AVN), pose significant reconstruction challenges.
• Femoral head allograft (FHA) is explored as a potential solution for these complex cases.

Purpose of the Study:

• To evaluate the efficacy and outcomes of ankle arthrodesis or tibiotalocalcaneal fusion utilizing FHA for patients with significant talar bone defects.

Main Methods:

• A retrospective review of 44 patients (45 ankles) who underwent ankle fusion with FHA between 2006 and 2019.
• Patients had a history of failed total ankle arthroplasty (TAA) or talar AVN.
• Pre- and postoperative functional scores (VR-12, FAAM, AOS, VAS) and patient satisfaction were assessed.

Main Results:

• Significant improvements were observed in physical function (VR-12 Physical), daily living activities (FAAM ADL), sports ability (FAAM Sport), pain, and disability (AOS, VAS).
• The overall fusion rate was 90.7% at an average of 18.7 weeks, with an overall patient satisfaction rate of 78.6%.
• Five patients experienced nonunions requiring revision surgery.

Conclusions:

• Femoral head allograft (FHA) is a viable option for reconstructing talar defects, leading to high arthrodesis rates.
• This approach demonstrates positive patient-reported outcomes in a challenging patient population with significant bone loss.