RESEARCH ARTICLE


Ankle Fusion Rates using Composite Peptide-enriched Bone Graft



Luke S. McKinnon1, Michael J. Symes1, Andrew Wines1, Rajat Mittal2, *
1 Sydney Orthopaedic Foot and Ankle Research Institute (SOFARI), St Leonards, Australia
2 Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia, Suite 10, Westmead Private Hospital, Cnr of Mons and Darcy Road, Westmead NSW 2145; Australia


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Creative Commons License
© 2024 The Author(s). Published by Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Orthopaedics and Trauma Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia, Suite 10, Westmead Private Hospital, Cnr of Mons and Darcy Road, Westmead NSW 2145; Australia; E-mail: rajatmittal.research@gmail.com


Abstract

Introduction

Joint fusion is a widely accepted treatment option for debilitating arthritis and deformity in the foot and ankle. Autologous bone grafting has long been accepted as the gold standard form of bone grafting; however, it can still be associated with non-union. This study aims to investigate joint fusion rates using Composite Peptide Enhanced Bone Graft (CPEBG) as an adjunct during ankle fusion surgery.

Methods

Data was collected retrospectively for patients over the age of 18 years, undergoing ankle fusion between June 2016 and August 2020 with autologous bone graft and CPEBG. All patients had their primary or secondary procedure performed by a single surgeon with follow-up at 6 and 12 months post-operatively. Data included baseline demographic data and procedural characteristics. The primary endpoint was to assess joint union at 6 and 12 months, respectively. Secondary objectives included post-operative pain, mobility and the use of walking aids.

Results

Radiographic union rates for the primary group were 40/48 (83%) and 43/48 (90%) at 6 and 12 months and 2/3 (67%) and 3/3 (100%) at 6 and 12 months for the secondary group, respectively. The overall non-union rate for primary ankle fusions was 8%, while no non-unions were observed in the secondary group.

Conclusion

CPEBG in foot and ankle fusion procedures yields similar union rates compared to other graft options. Further well-designed randomised control trials are warranted to confirm these findings.

Keywords: Ankle fusion, Bone graft, Foot, Ankle joint, Pain, Walking aids.