Roukis TS, Samsell B. A new approach to ankle and foot arthrodesis procedures using a living cellular bone matrix: a case series. Clin Res Foot Ankle. 2018 Sep 21;6(3):274.


As the number of foot and ankle arthrodesis procedures performed increases, new approaches are needed to decrease the rate of non or delayed unions, reduce the cost of medical care through minimizing need for revision surgery, and promote high-quality fusion of bone. Recently, a new allograft was developed from living cellular bone matrix, V-CBM, which provides the osteoconductive, osteoinductive, and osteogenic properties needed for fusion. V-CBM contains demineralized bone matrix (DBM) in addition to a viable cortico-cancellous bone matrix containing bone cells. The purpose of this case series is to provide the first such published clinical evidence of V-CBM efficacy when used in a variety of foot and ankle cases. This case series explores the use of V-CBM in four different types of foot and ankle fusion procedures, including ankle arthrodesis, double arthrodesis of the hindfoot, tibiotalocalcaneal arthrodesis, and modified Lapidus to correct hypermobility of the first tarsal-metatarsal joint. All surgeries were performed under thigh tourniquet control with continuous recovery observation and conversion to admission hospitalization in situations where pain control was not adequate to allow discharge home. Large C-arm image intensification was employed for all surgeries. All patients demonstrated fusion within 7.5 to 10 weeks and were weight bearing within two to three months. Follow-up time ranged from 8 to 20 months with no complications observed in any case. The successful outcomes reported here cannot be generalized but suggest V-CBM may be an effective approach for multiple types of foot and ankle bone fusion procedures and support further research.

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