Ankle Arthrodesis Using Fibular Bone Graft: A Depth Meta-analysis from 1991 to 2022

Area of Science:

• Orthopedic Surgery
• Regenerative Medicine

Background:

• Ankle arthrodesis using conventional methods has high failure and nonunion rates, particularly in high-risk patients.
• Fibular transplants are an alternative surgical approach for ankle fusion.

Purpose of the Study:

• To systematically review and evaluate the outcomes of ankle arthrodesis utilizing fibular transplants.
• To assess the efficacy of fibular grafts in improving ankle fusion rates and patient function.

Main Methods:

• Systematic review and meta-analysis of 20 selected articles from Embase and Medline searches.
• Quality assessment of included studies using Joanna Briggs Institute (JBI) criteria.
• Analysis of Ankle Osteoarthritis Score (AOFAS), time to full weight-bearing (FWB), and bone union rates.

Main Results:

• A total of 179 patients and ankles were analyzed, with 20 articles included in the review.
• High union rates were reported, with eight articles showing 100% union and others reporting a minimum of 82%.
• Significant improvement in AOFAS scores (22.5 points) and average bone healing time of 5.9 months were observed.

Conclusions:

• Fibular bone grafts demonstrate favorable outcomes in ankle arthrodesis, even in patients with comorbidities affecting bone healing.
• The fibular graft technique leads to satisfactory union rates and improved AOFAS scores, enhancing functional recovery.