Initial Experience with Tricortical Iliac Crest Bone Graft and Human Amniotic Allograft in Evans Calcaneal Osteotomy

J Joseph Anderson,Adam F Gough,Myron H Hansen,Zflan Swayzee

doi:10.4236/scd.2015.52002

Abstract

Background: Adult acquired flatfoot deformity is generally mediated with an Evans procedure where a wedge of bone is placed into the calcaneus to better align the foot and decrease the deformity. The purpose of this study was to assess the efficacy and safety of human amniotic allograft applied to allogeneic tri-cortical grafts in Evans calcaneal osteotomy. Methods: The medical records of patients who had Evans calcaneal osteotomy with implantation of tri-cortical iliac crest bone graft with human anmiotic allograft for surgical management of adult acquired flatfoot deformity with 2 years follow-up data were reviewed. Results: A total of 63 patients (mean age: 33.3 yr, range: 18 - 66 yr) were enrolled with adult acquired flatfoot deformity. Median time to weight-bearing was 6 weeks. Time to wearing normal shoes was 10 weeks, and time to radiographic healing was 16 weeks. Conclusions: The use of human amniotic allograft did not diminish the long term outcome of procedure or the short term benchmarks for healing after surgery. There were no nonunion, wound dehiscence, infection, or allergic or immune reaction reported. This retrospective study demonstrated that tri-cortical iliac crest bone graft and HAA could be safely used in Evans calcaneal osteotomy with favorable results.

Highlights

This adult acquired flatfoot deformity (AAFD) presents a therapeutic challenge to foot and ankle specialists.How to cite this paper: Anderson, J.J., Gough, A.F., Hansen, M.H. and Swayzee, Z. (2015) Initial Experience with Tricortical Iliac Crest Bone Graft and Human Amniotic Allograft in Evans Calcaneal Osteotomy
The Evans calcaneal osteotomy has become a primary surgical treatment for AAFD where a major portion of the deformity is in the transverse plane [1]
The average for weight-bearing, time into shoes and radiographic healing were, in weeks, 6.12, 10.07 and 16.21 respectively. They were not significantly different when compared to the normal range of healing after an Evans calcaneal osteotomy and tri-cortical iliac crest bone graft of about 6 weeks to weight-bearing, 10-12 weeks for time in shoes and 12 - 16 weeks for radiographic healing

Summary

Introduction

This adult acquired flatfoot deformity (AAFD) presents a therapeutic challenge to foot and ankle specialists.How to cite this paper: Anderson, J.J., Gough, A.F., Hansen, M.H. and Swayzee, Z. (2015) Initial Experience with Tricortical Iliac Crest Bone Graft and Human Amniotic Allograft in Evans Calcaneal Osteotomy. (2015) Initial Experience with Tricortical Iliac Crest Bone Graft and Human Amniotic Allograft in Evans Calcaneal Osteotomy. Adult acquired flatfoot deformity is generally mediated with an Evans procedure where a wedge of bone is placed into the calcaneus to better align the foot and decrease the deformity. The purpose of this study was to assess the efficacy and safety of human amniotic allograft applied to allogeneic tri-cortical grafts in Evans calcaneal osteotomy. Methods: The medical records of patients who had Evans calcaneal osteotomy with implantation of tri-cortical iliac crest bone graft with human anmiotic allograft for surgical management of adult acquired flatfoot deformity with 2 years follow-up data were reviewed. There were no nonunion, wound dehiscence, infection, or allergic or immune reaction reported This retrospective study demonstrated that tri-cortical iliac crest bone graft and HAA could be safely used in Evans calcaneal osteotomy with favorable results

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