BONE-GRAFT IN HINDFOOT ARTHRODESIS - ALLOGRAFT VS AUTOGRAFT

From 1990 to 1992, all arthrodeses of the so-called triple joints, com bined or isolated and performed by one surgeon, were reviewed to allow a minimum follow up of 18 months from the time of the index procedure , Type of bone graft was selected based on the patients' decision afte r the risks of each were explained by the surgeon, There were 37 patie nts undergoing 41 procedures (4 bilateral) including double and triple arthrodesis, as well as isolated subtalar fusions, Twenty-nine of the se were performed for either degenerative or posttraumatic arthritis, Ten others mere performed for joint incongruity resulting from posteri or tibial tendon insufficiency, and the rest for hemiparesis or residu al clubfoot, All patients were placed into a routine postoperative reg imen of casting, bracing, weight bearing, and therapy, They were evalu ated based on subjective complaints, physical examination, and postope rative radiographs, Any patient suspected of having a nonunion underwe nt a computed tomography scan for confirmation, Overall 24 patients re ceived allografts and 17 iliac crest grafts, There were four nonunions , three of which utilized banked bone graft, with the only nonunion in the autograft group occurring in a patient following open calcaneus f racture, Of the four nonunions, three opted for revision surgery and t he only one to choose allograft again incurred the only recurrent nonu nion, There were two infections, one in each group, resulting in prolo nged intravenous antibiotic therapy.