Individual Concepts in Foot Surgery: A Comparison of Xenogeneic and Autologous Bone Grafts Used in Adults for Lateral Calcaneus-Lengthening Osteotomy According to Evans
Background: Xenogeneic bone grafts, when compared to autologous grafts, are supposed to provide structural benefits without donor site morbidity. To date, there have been divergent results in the use of xenogeneic grafts in foot surgery, primarily in pediatric patient cohorts. The present study exam...
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MDPI AG
2022-12-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/1/95 |
| _version_ | 1797440087222386688 |
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| author | Markus Siegel Lisa Bode Leonard Simon Brandenburg Andreas Frodl Hagen Schmal Jan Kühle |
| author_facet | Markus Siegel Lisa Bode Leonard Simon Brandenburg Andreas Frodl Hagen Schmal Jan Kühle |
| author_sort | Markus Siegel |
| collection | DOAJ |
| description | Background: Xenogeneic bone grafts, when compared to autologous grafts, are supposed to provide structural benefits without donor site morbidity. To date, there have been divergent results in the use of xenogeneic grafts in foot surgery, primarily in pediatric patient cohorts. The present study examines the incorporation and maintenance of the achieved correction using autologous and xenogeneic bone grafts in adult patients with a six-month follow-up period. Material/Methods: In this retrospective study, 31 adult patients (43 feet in total) treated in our clinic by a lateral calcaneus-lengthening osteotomy, according to Evans, between 01/2006 and 12/2020 were included. The patients were assigned to study groups according to the use of xenogeneic or autologous bone grafts. The osseous incorporation following the criteria of Worth et al., correction maintenance by measuring the talo-navicular coverage angle (TNCA), the talo-first metatarsal angle (TFMA), the calcaneal pitch angle (PCA) and necessary revisions six months after surgery were extracted from the medical files retrospectively. Furthermore, the medical files were screened for the relevant comorbidities, nicotine abuse, BMI, sex and age. Results: In total, 27 autogenous (iliac crest) and 16 xenogeneic bone grafts of bovine origin were used. The evaluation of the radiographs at follow-up demonstrated that there was a mean incorporation rate of 96.3% for the autologous grafts and 57% for the patients treated with xenogeneic grafts (<i>p</i> = 0.002). Compared to the autologous group, xenogeneic grafts did not increase the loss of hindfoot alignment in the postoperative course, regardless of being incorporated or not. ΔTNCA, ΔTFMA and ΔPCA displayed no significant differences in both groups (<i>p</i> = 0.45, <i>p</i> = 0.42 and <i>p</i> = 0.10). Conclusion: Despite a significantly lower incorporation rate, the use of xenogeneic grafts was not accompanied with a greater risk of hindfoot alignment loss in the first six months after surgery. Early revision after a postoperative course of six months should not be motivated solely by the radiographic picture of incomplete osseous integration. |
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| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T12:03:05Z |
| publishDate | 2022-12-01 |
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| spelling | doaj.art-c35f7be157ca4fa4b51f7ed97064952b2023-11-30T23:02:04ZengMDPI AGJournal of Personalized Medicine2075-44262022-12-011319510.3390/jpm13010095Individual Concepts in Foot Surgery: A Comparison of Xenogeneic and Autologous Bone Grafts Used in Adults for Lateral Calcaneus-Lengthening Osteotomy According to EvansMarkus Siegel0Lisa Bode1Leonard Simon Brandenburg2Andreas Frodl3Hagen Schmal4Jan Kühle5Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Albert-Ludwigs University Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Albert-Ludwigs University Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Oral and Maxillofacial Surgery, Freiburg University Hospital, Albert-Ludwigs University Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Albert-Ludwigs University Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Albert-Ludwigs University Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyDepartment of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Albert-Ludwigs University Freiburg, Hugstetter Straße 55, 79106 Freiburg, GermanyBackground: Xenogeneic bone grafts, when compared to autologous grafts, are supposed to provide structural benefits without donor site morbidity. To date, there have been divergent results in the use of xenogeneic grafts in foot surgery, primarily in pediatric patient cohorts. The present study examines the incorporation and maintenance of the achieved correction using autologous and xenogeneic bone grafts in adult patients with a six-month follow-up period. Material/Methods: In this retrospective study, 31 adult patients (43 feet in total) treated in our clinic by a lateral calcaneus-lengthening osteotomy, according to Evans, between 01/2006 and 12/2020 were included. The patients were assigned to study groups according to the use of xenogeneic or autologous bone grafts. The osseous incorporation following the criteria of Worth et al., correction maintenance by measuring the talo-navicular coverage angle (TNCA), the talo-first metatarsal angle (TFMA), the calcaneal pitch angle (PCA) and necessary revisions six months after surgery were extracted from the medical files retrospectively. Furthermore, the medical files were screened for the relevant comorbidities, nicotine abuse, BMI, sex and age. Results: In total, 27 autogenous (iliac crest) and 16 xenogeneic bone grafts of bovine origin were used. The evaluation of the radiographs at follow-up demonstrated that there was a mean incorporation rate of 96.3% for the autologous grafts and 57% for the patients treated with xenogeneic grafts (<i>p</i> = 0.002). Compared to the autologous group, xenogeneic grafts did not increase the loss of hindfoot alignment in the postoperative course, regardless of being incorporated or not. ΔTNCA, ΔTFMA and ΔPCA displayed no significant differences in both groups (<i>p</i> = 0.45, <i>p</i> = 0.42 and <i>p</i> = 0.10). Conclusion: Despite a significantly lower incorporation rate, the use of xenogeneic grafts was not accompanied with a greater risk of hindfoot alignment loss in the first six months after surgery. Early revision after a postoperative course of six months should not be motivated solely by the radiographic picture of incomplete osseous integration.https://www.mdpi.com/2075-4426/13/1/95calcaneus osteotomyEvansautologousxenogeneicbone graft |
| spellingShingle | Markus Siegel Lisa Bode Leonard Simon Brandenburg Andreas Frodl Hagen Schmal Jan Kühle Individual Concepts in Foot Surgery: A Comparison of Xenogeneic and Autologous Bone Grafts Used in Adults for Lateral Calcaneus-Lengthening Osteotomy According to Evans Journal of Personalized Medicine calcaneus osteotomy Evans autologous xenogeneic bone graft |
| title | Individual Concepts in Foot Surgery: A Comparison of Xenogeneic and Autologous Bone Grafts Used in Adults for Lateral Calcaneus-Lengthening Osteotomy According to Evans |
| title_full | Individual Concepts in Foot Surgery: A Comparison of Xenogeneic and Autologous Bone Grafts Used in Adults for Lateral Calcaneus-Lengthening Osteotomy According to Evans |
| title_fullStr | Individual Concepts in Foot Surgery: A Comparison of Xenogeneic and Autologous Bone Grafts Used in Adults for Lateral Calcaneus-Lengthening Osteotomy According to Evans |
| title_full_unstemmed | Individual Concepts in Foot Surgery: A Comparison of Xenogeneic and Autologous Bone Grafts Used in Adults for Lateral Calcaneus-Lengthening Osteotomy According to Evans |
| title_short | Individual Concepts in Foot Surgery: A Comparison of Xenogeneic and Autologous Bone Grafts Used in Adults for Lateral Calcaneus-Lengthening Osteotomy According to Evans |
| title_sort | individual concepts in foot surgery a comparison of xenogeneic and autologous bone grafts used in adults for lateral calcaneus lengthening osteotomy according to evans |
| topic | calcaneus osteotomy Evans autologous xenogeneic bone graft |
| url | https://www.mdpi.com/2075-4426/13/1/95 |
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