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. 2025 Apr 16;107(8):e33.
doi: 10.2106/JBJS.24.00580. Epub 2025 Feb 25.

Outcomes of Autogenous Bone Grafting for Periprosthetic Osteolysis After Total Ankle Arthroplasty: Clinical and 3-Dimensional Computed Tomography Results

Yeo Kwon Yoon  1 , Kwang Hwan Park  2 , Dong Woo Shim  2 , Wonwoo Lee  2 , Jae Seok Chae  3 , Seung Hwan Han  4 , Jin Woo Lee  2
Affiliations

Outcomes of Autogenous Bone Grafting for Periprosthetic Osteolysis After Total Ankle Arthroplasty: Clinical and 3-Dimensional Computed Tomography Results

Yeo Kwon Yoon et al. J Bone Joint Surg Am. .

Abstract

Background: Periprosthetic osteolysis after total ankle arthroplasty (TAA) is a substantial problem. Bone grafting may be beneficial in the treatment of large osteolytic cysts; however, the literature regarding the outcomes of bone grafting is limited. This study analyzed the outcomes of autogenous bone grafting performed for the management of periprosthetic osteolysis following TAA.

Methods: We retrospectively reviewed 42 ankles (41 Korean patients) that underwent autogenous bone grafting for periprosthetic osteolysis following TAA. Clinical outcomes were evaluated using visual analog scale for pain scores, Ankle Osteoarthritis Scale pain and disability scores, and American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Scale scores. Computed tomography (CT) was performed preoperatively and for at least 2 years postoperatively in order to evaluate the treatment response. Histology, prosthesis survivorship, reoperations, and complications were also evaluated.

Results: The mean time to autogenous bone grafting was 64.4 months (range, 10 to 128 months), and the mean follow-up duration after autogenous bone grafting was 70.7 months (range, 24 to 137 months). All clinical scores significantly improved from preoperatively to the last follow-up visit. The mean osteolytic cyst volume improved from 4.8 cm 3 (range, 1.1 to 19.4 cm 3 ) to 0.8 cm 3 (range, 0 to 6.5 cm 3 ). A Kaplan-Meier survival analysis revealed that TAA with subsequent bone grafting was associated with similar prosthesis survivorship (100% and 85.7% at 5 and 10 years, respectively) but inferior reoperation-free survivorship (93.4% and 68.4% at 5 and 10 years, respectively) compared with TAA without osteolysis or with non-progressive osteolysis.

Conclusions: Autogenous bone grafting performed for the management of periprosthetic osteolysis after TAA produced favorable clinical and radiographic outcomes. However, there was still a higher risk of subsequent surgery even after successful bone grafting, compared with TAA without osteolysis or with non-progressive osteolysis. Our results suggest that autogenous bone grafting and serial CT scan monitoring over time may prolong the survivorship of TAA prostheses in ankles with periprosthetic osteolysis.

Level of evidence: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

Disclosure: This study was supported by a faculty research grant from Yonsei University College of Medicine (6-2022-0167) and by the Korea Institute for Advancement of Technology grant funded by the Government of the Republic of Korea (Ministry of Trade, Industry and Energy; no. P0013646).The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article ( http://links.lww.com/JBJS/I455 ).

References

    1. Kim HJ, Suh DH, Yang JH, Lee JW, Kim HJ, Ahn HS, Han SW, Choi GW. Total ankle arthroplasty versus ankle arthrodesis for the treatment of end-stage ankle arthritis: a meta-analysis of comparative studies. Int Orthop. 2017 Jan;41(1):101-1-10.
    1. Cody EA, Scott DJ, Easley ME. Total Ankle Arthroplasty: A Critical Analysis Review. JBJS Rev. 2018 Aug;6(8):e8.
    1. Shih CL, Chen SJ, Huang PJ. Clinical Outcomes of Total Ankle Arthroplasty Versus Ankle Arthrodesis for the Treatment of End-Stage Ankle Arthritis in the Last Decade: a Systematic Review and Meta-analysis. J Foot Ankle Surg. 2020 Sep-Oct;59(5):1032-1-10.
    1. Fanelli D, Mercurio M, Castioni D, Sanzo V, Gasparini G, Galasso O. End-stage ankle osteoarthritis: arthroplasty offers better quality of life than arthrodesis with similar complication and re-operation rates-an updated meta-analysis of comparative studies. Int Orthop. 2021 Sep;45(9):2177-1-10.
    1. van der Plaat LW, Hoornenborg D, Sierevelt IN, van Dijk CN, Haverkamp D. Ten-year revision rates of contemporary total ankle arthroplasties equal 22%. A meta-analysis. Foot Ankle Surg. 2022 Jul;28(5):543-1-10.

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