Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2013

Open Access 01-12-2013 | Research article

Substitutes of structural and non-structural autologous bone grafts in hindfoot arthrodeses and osteotomies: a systematic review

Authors: Marc Andreas Müller, Alexander Frank, Matthias Briel, Victor Valderrabano, Patrick Vavken, Vahid Entezari, Arne Mehrkens

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

Login to get access

Abstract

Background

Structural and non-structural substitutes of autologous bone grafts are frequently used in hindfoot arthrodeses and osteotomies. However, their efficacy is unclear.
The primary goal of this systematic review was to compare autologous bone grafts with structural and non-structural substitutes regarding the odds of union in hindfoot arthrodeses and osteotomies.

Methods

The Medline and EMBASE and Cochrane databases were searched for relevant randomized and non-randomized prospective studies as well as retrospective comparative chart reviews.

Results

10 studies which comprised 928 hindfoot arthrodeses and osteotomies met the inclusion criteria for this systematic review. The quality of the retrieved studies was low due to small samples sizes and confounding variables. The pooled random effect odds for union were 12.8 (95% CI 12.7 to 12.9) for structural allografts, 5.7 (95% CI 5.5 to 6.0) for cortical autologous grafts, 7.3 (95% CI 6.0 to 8.6) for cancellous allografts and 6.0 (95% CI 5.7 to 6.4) for cancellous autologous grafts. In individual studies, the odds of union in hindfoot arthrodeses achieved with cancellous autologous grafts was similar to those achieved with demineralised bone matrix or platelet derived growth factor augmented ceramic granules.

Conclusion

Our results suggest an equivalent incorporation of structural allografts as compared to autologous grafts in hindfoot arthrodeses and osteotomies. There is a need for prospective randomized trials to further clarify the role of substitutes of autologous bone grafts in hindfoot surgery.
Appendix
Available only for authorised users
Literature
1.
Kelly IP, Easley ME: Treatment of stage 3 adult acquired flatfoot. Foot Ankle Clin. 2001, 6: 153-166. 10.1016/S1083-7515(03)00073-1.CrossRefPubMed
2.
Kitaoka HB, Patzer GL: Subtalar arthrodesis for posterior tibial tendon dysfunction and pes planus. Clin Orthop Relat Res. 1997, 345: 187-194.CrossRefPubMed
3.
Bolt PM, Coy S, Toolan BC: A comparison of lateral column lengthening and medial translational osteotomy of the calcaneus for the reconstruction of adult acquired flatfoot. Foot Ankle Int. 2007, 28: 1115-1123. 10.3113/FAI.2007.1115.CrossRefPubMed
4.
Easley ME, Trnka HJ, Schon LC, Myerson MS: Isolated subtalar arthrodesis. J Bone Joint Surg Am. 2000, 82: 613-624.PubMed
5.
Glanzmann MC, Sanhueza-Hernandez R: Arthroscopic subtalar arthrodesis for symptomatic osteoarthritis of the hindfoot: a prospective study of 41 cases. Foot Ankle Int. 2007, 28: 2-7. 10.3113/FAI.2007.0001.CrossRefPubMed
6.
Harstall R, Lehmann O, Krause F, Weber M: Supramalleolar lateral closing wedge osteotomy for the treatment of varus ankle arthrosis. Foot Ankle Int. 2007, 28: 542-548. 10.3113/FAI.2007.0542.CrossRefPubMed
7.
Myerson M, Quill GE: Late complications of fractures of the calcaneus. J Bone Joint Surg Am. 1993, 75: 331-341.PubMed
8.
Chan SC, Alexander IJ: Subtalar arthrodesis with interposition tricortical iliac crest graft for late pain and deformity after calcaneus fracture. Foot Ankle Int. 1997, 18: 613-615. 10.1177/107110079701801002.CrossRefPubMed
9.
Mann DC, Hsu JD: Triple arthrodesis in the treatment of fixed cavovarus deformity in adolescent patients with Charcot-Marie-Tooth disease. Foot Ankle. 1992, 13: 1-6. 10.1177/107110079201300101.CrossRefPubMed
10.
Santavirta S, Turunen V, Ylinen P, Konttinen YT, Tallroth K: Foot and ankle fusions in Charcot-Marie-Tooth disease. Arch Orthop Trauma Surg. 1993, 112: 175-179. 10.1007/BF00662284.CrossRefPubMed
11.
Bednarz PA, Beals TC, Manoli A: Subtalar distraction bone block fusion: an assessment of outcome. Foot Ankle Int. 1997, 18: 785-791. 10.1177/107110079701801206.CrossRefPubMed
12.
Jones CP, Coughlin MJ, Shurnas PS: Prospective CT scan evaluation of hindfoot nonunions treated with revision surgery and low-intensity ultrasound stimulation. Foot Ankle Int. 2006, 27: 229-235.PubMed
13.
Myerson MS, Neufeld SK, Uribe J: Fresh-frozen structural allografts in the foot and ankle. J Bone Joint Surg Am. 2005, 87: 113-120. 10.2106/JBJS.C.01735.CrossRefPubMed
14.
Thordarson DB, Kuehn S: Use of demineralized bone matrix in ankle/hindfoot fusion. Foot Ankle Int. 2003, 24: 557-560.CrossRefPubMed
15.
Chahal J, Stephen DJ, Bulmer B, Daniels T, Kreder HJ: Factors associated with outcome after subtalar arthrodesis. J Orthop Trauma. 2006, 20: 555-561. 10.1097/01.bot.0000211156.13487.6a.CrossRefPubMed
16.
Ishikawa SN, Murphy GA, Richardson EG: The effect of cigarette smoking on hindfoot fusions. Foot Ankle Int. 2002, 23: 996-998.CrossRefPubMed
17.
Danko AM, Allen B, Pugh L, Stasikelis P: Early graft failure in lateral column lengthening. J Pediatr Orthop. 2004, 24: 716-720. 10.1097/01241398-200411000-00022.CrossRefPubMed
18.
Child BJ, Hix J, Catanzariti AR, Mendicino RW, Saltrick K: The effect of hindfoot realignment in triple arthrodesis. J Foot Ankle Surg. 2009, 48: 285-293. 10.1053/j.jfas.2009.02.006.CrossRefPubMed
19.
Burchardt H: The biology of bone graft repair. Clin Orthop Relat Res. 1983, 174: 28-42.PubMed
20.
Dell PC, Burchardt H, Glowczewskie FP: A roentgenographic, biomechanical, and histological evaluation of vascularized and non-vascularized segmental fibular canine autografts. J Bone Joint Surg Am. 1985, 67: 105-112.PubMed
21.
Zerbo IR, de Lange GL, Joldersma M, Bronckers AL, Burger EH: Fate of monocortical bone blocks grafted in the human maxilla: a histological and histomorphometric study. Clin Oral Implants Res. 2003, 14: 759-766. 10.1046/j.0905-7161.2003.00967.x.CrossRefPubMed
22.
Einhorn TA, Majeska RJ, Rush EB, Levine PM, Horowitz MC: The expression of cytokine activity by fracture callus. J Bone Miner Res. 1995, 10: 1272-1281.CrossRefPubMed
23.
Albrektsson T, Albrektsson B: Microcirculation in grafted bone. A chamber technique for vital microscopy of rabbit bone transplants. Acta Orthop Scand. 1978, 49: 1-7. 10.3109/17453677809005716.CrossRefPubMed
24.
Enneking WF, Burchardt H, Puhl JJ, Piotrowski G: Physical and biological aspects of repair in dog cortical-bone transplants. J Bone Joint Surg Am. 1975, 57: 237-252.PubMed
25.
DeOrio JK, Farber DC: Morbidity associated with anterior iliac crest bone grafting in foot and ankle surgery. Foot Ankle Int. 2005, 26: 147-151.PubMed
26.
Ahlmann E, Patzakis M, Roidis N, Shepherd L, Holtom P: Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Joint Surg Am. 2002, 84-A: 716-720.PubMed
27.
Arrington ED, Smith WJ, Chambers HG, Bucknell AL, Davino NA: Complications of iliac crest bone graft harvesting. Clin Orthop Relat Res. 1996, 329: 300-309.CrossRefPubMed
28.
Younger EM, Chapman MW: Morbidity at bone graft donor sites. J Orthop Trauma. 1989, 3: 192-195. 10.1097/00005131-198909000-00002.CrossRefPubMed
29.
Enneking WF, Campanacci DA: Retrieved human allografts: a clinicopathological study. J Bone Joint Surg Am. 2001, 83-A: 971-986.PubMed
30.
Simonds RJ: HIV transmission by organ and tissue transplantation. AIDS. 1993, 7 (Suppl 2): S35-S38.CrossRefPubMed
31.
Langer F, Czitrom A, Pritzker KP, Gross AE: The immunogenicity of fresh and frozen allogeneic bone. J Bone Joint Surg Am. 1975, 57: 216-220.PubMed
32.
Preston RD, Meinberg TA, Payne JB, Schmid MJ, Lee HM, Golub LM: Inflammatory mediator release following bone grafting in humans: a pilot study. J Clin Periodontol. 2007, 34: 797-804. 10.1111/j.1600-051X.2007.01117.x.CrossRefPubMed
33.
Weiland AJ, Phillips TW, Randolph MA: Bone grafts: a radiologic, histologic, and biomechanical model comparing autografts, allografts, and free vascularized bone grafts. Plast Reconstr Surg. 1984, 74: 368-379. 10.1097/00006534-198409000-00006.CrossRefPubMed
34.
Wilson JW, Rhinelander FW, Stewart CL: Vascularization of cancellous chip bone grafts. Am J Vet Res. 1985, 46: 1691-1699.PubMed
35.
Wheeler DL, Enneking WF: Allograft bone decreases in strength in vivo over time. Clin Orthop Relat Res. 2005, 435: 36-42.CrossRefPubMed
36.
Nguyen H, Morgan DA, Forwood MR: Sterilization of allograft bone: effects of gamma irradiation on allograft biology and biomechanics. Cell Tissue Bank. 2007, 8: 93-105. 10.1007/s10561-006-9020-1.CrossRefPubMed
37.
Trentz OA, Hoerstrup SP, Sun LK, Bestmann L, Platz A, Trentz OL: Osteoblasts response to allogenic and xenogenic solvent dehydrated cancellous bone in vitro. Biomaterials. 2003, 24: 3417-3426. 10.1016/S0142-9612(03)00205-9.CrossRefPubMed
38.
Jahn K, Braunstein V, Furlong PI, Simpson AE, Richards RG, Stoddart MJ: A rapid method for the generation of uniform acellular bone explants: a technical note. J Orthop Surg Res. 2010, 5: 32-10.1186/1749-799X-5-32.CrossRefPubMedPubMedCentral
39.
Meyer S, Floerkemeier T, Windhagen H: Histological osseointegration of Tutobone((R)): first results in human. Arch Orthop Trauma Surg. 2007, 128: 539-544.CrossRefPubMed
40.
Urist MR: Bone: formation by autoinduction. Clin Orthop Relat Res. 1965, 2002: 4-10.
41.
Soohoo NF, Cracchiolo A: The results of utilizing proximal tibial bone graft in reconstructive procedures of the foot and ankle. Foot Ankle Surg. 2008, 14: 62-66. 10.1016/j.fas.2007.10.003.CrossRefPubMed
42.
Wang JC, Alanay A, Mark D, Kanim LE, Campbell PA, Dawson EG: A comparison of commercially available demineralized bone matrix for spinal fusion. Eur Spine J. 2007, 16: 1233-1240. 10.1007/s00586-006-0282-x.CrossRefPubMedPubMedCentral
43.
Schwartz Z, Somers A, Mellonig JT, Carnes DL, Dean DD, Cochran DL: Ability of commercial demineralized freeze-dried bone allograft to induce new bone formation is dependent on donor age but not gender. J Periodontol. 1998, 69: 470-478. 10.1902/jop.1998.69.4.470.CrossRefPubMed
44.
Ohgushi H, Goldberg VM, Caplan AI: Repair of bone defects with marrow cells and porous ceramic. Experiments in rats. Acta Orthop Scand. 1989, 60: 334-339. 10.3109/17453678909149289.CrossRefPubMed
45.
Frigg A, Dougall H, Boyd S, Nigg B: Can porous tantalum be used to achieve ankle and subtalar arthrodesis?: a pilot study. Clin Orthop Relat Res. 2010, 468: 209-216. 10.1007/s11999-009-0948-x.CrossRefPubMed
46.
El-Amin SF, Hogan MV, Allen AA, Hinds J, Laurencin CT: The indications and use of bone morphogenetic proteins in foot, ankle, and tibia surgery. Foot Ankle Clin. 2010, 15: 543-551. 10.1016/j.fcl.2010.08.001.CrossRefPubMed
47.
DiGiovanni CW, Petricek JM: The evolution of rhPDGF-BB in musculoskeletal repair and its role in foot and ankle fusion surgery. Foot Ankle Clin. 2010, 15: 621-640. 10.1016/j.fcl.2010.07.001.CrossRefPubMed
48.
Stang A: Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010, 25: 603-605. 10.1007/s10654-010-9491-z.CrossRefPubMed
49.
Dersimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials. 1986, 7: 177-188. 10.1016/0197-2456(86)90046-2.CrossRefPubMed
50.
Egger M, Davey SG, Schneider M, Minder C: Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997, 315: 629-634. 10.1136/bmj.315.7109.629.CrossRefPubMedPubMedCentral
51.
Dolan CM, Henning JA, Anderson JG, Bohay DR, Kornmesser MJ, Endres TJ: Randomized prospective study comparing tri-cortical iliac crest autograft to allograft in the lateral column lengthening component for operative correction of adult acquired flatfoot deformity. Foot Ankle Int. 2007, 28: 8-12. 10.3113/FAI.2007.0002.CrossRefPubMed
52.
Templin D, Jones K, Weiner DS: The incorporation of allogeneic and autogenous bone graft in healing of lateral column lengthening of the calcaneus. J Foot Ankle Surg. 2008, 47: 283-287. 10.1053/j.jfas.2008.02.018.CrossRefPubMed
53.
Kwak YH, Park KB, Park HW, Kim HW: Use of allograft in skeletally immature patients for calcaneal neck lengthening osteotomy. Yonsei Med J. 2008, 49: 79-83. 10.3349/ymj.2008.49.1.79.CrossRefPubMedPubMedCentral
54.
Grier KM, Walling AK: The use of tricortical autograft versus allograft in lateral column lengthening for adult acquired flatfoot deformity: an analysis of union rates and complications. Foot Ankle Int. 2010, 31: 760-769. 10.3113/FAI.2010.0760.CrossRefPubMed
55.
Mahan KT, Hillstrom HJ:Bone grafting in foot and ankle surgery. A review of 300 cases. J Am Podiatr Med Assoc. 1998, 88: 109-118.CrossRefPubMed
56.
DiGiovanni CW, Baumhauer J, Lin SS, Berberian WS, Flemister AS, Enna MJ: Prospective, randomized, multi-center feasibility trial of rhPDGF-BB versus autologous bone graft in a foot and ankle fusion model. Foot Ankle Int. 2011, 32: 344-354. 10.3113/FAI.2011.0344.CrossRefPubMed
57.
Michelson JD, Curl LA:Use of demineralized bone matrix in hindfoot arthrodesis. Clin Orthop Relat Res. 1996, 325: 203-208.CrossRefPubMed
58.
McGarvey WC, Braly WG:Bone graft in hindfoot arthrodesis: allograft vs autograft. Orthopedics. 1996, 19: 389-394.PubMed
59.
Coughlin MJ, Grimes JS, Traughber PD, Jones CP: Comparison of radiographs and CT scans in the prospective evaluation of the fusion of hindfoot arthrodesis. Foot Ankle Int. 2006, 27: 780-787.PubMed
60.
Cook EA, Cook JJ: Bone graft substitutes and allografts for reconstruction of the foot and ankle. Clin Podiatr Med Surg. 2009, 26: 589-605. 10.1016/j.cpm.2009.07.003.CrossRefPubMed
61.
Panchbhavi VK: Synthetic bone grafting in foot and ankle surgery. Foot Ankle Clin. 2010, 15: 559-576. 10.1016/j.fcl.2010.07.004.CrossRefPubMed
62.
Rush SM: Bone graft substitutes: osteobiologics. Clin Podiatr Med Surg. 2005, 22: 30-619. viiiCrossRef
63.
Boone DW: Complications of iliac crest graft and bone grafting alternatives in foot and ankle surgery. Foot Ankle Clin. 2003, 8: 1-14. 10.1016/S1083-7515(02)00128-6.CrossRefPubMed
64.
Agarwal R, Williams K, Umscheid CA, Welch WC: Osteoinductive bone graft substitutes for lumbar fusion: a systematic review. J Neurosurg Spine. 2009, 11: 729-740. 10.3171/2009.6.SPINE08669.CrossRefPubMed
65.
Lee KJ, Roper JG, Wang JC: Demineralized bone matrix and spinal arthrodesis. Spine J. 2005, 5: 217S-223S. 10.1016/j.spinee.2005.02.006.CrossRefPubMed
66.
Miller LE, Block JE: Safety and Effectiveness of Bone Allografts in Anterior Cervical Discectomy and Fusion Surgery. Spine (Phila Pa 1976). 2011, 36: 2045-10.1097/BRS.0b013e3181ff37eb.CrossRef
67.
Papakostidis C, Kontakis G, Bhandari M, Giannoudis PV: Efficacy of autologous iliac crest bone graft and bone morphogenetic proteins for posterolateral fusion of lumbar spine: a meta-analysis of the results. Spine (Phila Pa 1976). 2008, 33: 680-692. 10.1097/BRS.0b013e3181844eca.CrossRef
68.
Epstein NE: Efficacy of different bone volume expanders for augmenting lumbar fusions. Surg Neurol. 2008, 69: 16-19. 10.1016/j.surneu.2007.03.021.CrossRefPubMed
69.
Vaccaro AR, Chiba K, Heller JG, Patel TC, Thalgott JS, Truumees E: Bone grafting alternatives in spinal surgery. Spine J. 2002, 2: 206-215. 10.1016/S1529-9430(02)00180-8.CrossRefPubMed
70.
71.
Bostrom MP, Seigerman DA: The clinical use of allografts, demineralized bone matrices, synthetic bone graft substitutes and osteoinductive growth factors: a survey study. HSS J. 2005, 1: 9-18. 10.1007/s11420-005-0111-5.CrossRefPubMedPubMedCentral
Metadata
Title
Substitutes of structural and non-structural autologous bone grafts in hindfoot arthrodeses and osteotomies: a systematic review
Authors
Marc Andreas Müller
Alexander Frank
Matthias Briel
Victor Valderrabano
Patrick Vavken
Vahid Entezari
Arne Mehrkens
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-14-59

Other articles of this Issue 1/2013

BMC Musculoskeletal Disorders 1/2013 Go to the issue

Research article

Muscle activity and head kinematics in unconstrained movements in subjects with chronic neck pain; cervical motor dysfunction or low exertion motor output?

Research article

Delta III reverse shoulder arthroplasty in the treatment of complex 3- and 4-part fractures of the proximal humerus: 6 to 42 months of follow up

Research article

Response of human chondrocytes and mesenchymal stromal cells to a decellularized human dermis

Erratum

Erratum to: study protocol: improving patient choice in treating Low back pain (IMPACT - LBP): a randomised controlled trial of a decision support package for use in physical therapy

Study protocol

Evaluation of the effect of a comprehensive multidisciplinary care pathway for hip fractures: design of a controlled study

Research article

Physical activity during life course and bone mass: a systematic review of methods and findings from cohort studies with young adults