Table 2 Studies comparing non-structural autologous bone grafts with substitutes in hindfoot arthrodeses and osteotomies
Ref. | Methodology | Results | Quality |
|---|---|---|---|
Cancellous allografts versus cancellous autologous grafts in hindfoot ADs | |||
McGarvey et al.[58] | Retrospective comparative chart review (1990–1992) | Rate of union | Selection: *** |
Allografts: 21/24 (88%) | Comparability: | ||
24 acellular allograft chips vs 17 cancellous autologous grafts in 37 subtalar, double and triple ADs. FU: Minimum 18 months | Autologous grafts: 16/17 (94%) | Outcome:* | |
P=? | |||
Time-to- union | |||
Triple/Double/Subtalar AD | |||
Allografts: 4.0/4.0/4.1 months | |||
Autologous grafts 3.0/3.2/3.6 months | |||
P= n. s | |||
Easley et al.[4] | Subgroup comparison in a retrospective chart review (1988–1995) | Rate of union | Selection: ** |
Allografts: 14/17 (82%) | Comparability: | ||
17 cancellous allograft vs. 94 cancellous autologous grafts in subtalar ADs. Mean FU 51 months(range: 24–130 months) | Autologous grafts: 80/94 (85%) | Outcome:* | |
P= n. s. | |||
Time –to- union | |||
Allografts: 13 weeks | |||
(10–24 weeks) | |||
Autologous grafts: 11weeks (8–20 weeks) | |||
P= n. s | |||
DBM versus cancellous autologous grafts in hindfoot ADs | |||
Michelson et al.[57] | Prospective comparative study (1990–1993) | Rate of union | Selection: *** |
37 DBM vs.18 cancellous autologous grafts in 11 subtalar AD’s, and 44 triple AD’s FU: Until complete healing | DBM: 36/37 (97%) | Comparability: | |
Autologous grafts: 16/18 (89%) | Outcome:*** | ||
P= n. s. | |||
Time –to-union | |||
DBM: 3.0 – 3.4 months | |||
Autologous grafts 2.7-3.7 months | |||
P=n. s. | |||
No graft versus cancellous autologous grafts in hindfoot ADs | |||
Easley et al. [4] | Subgroup comparison in a retrospective chart review (1988–1995) | Rate of union | Selection: ** |
No graft: 34/39 (87%) | Comparability: | ||
39 “no graft” vs 94 cancellous autologous grafts in isolated subtalar ADs. Mean FU 54 months (range: 24–130 months) | Autologous grafts: 80/94 (85%) | Outcome:* | |
P= n. s. | |||
Time-to-union | |||
No graft: 11w (8–24) | |||
Autologous grafts: 11weeks (8–20 weeks) | |||
P= n. s | |||
Synthetic bone grafts versus cancellous autologous grafts in hindfoot ADs | |||
DiGiovanni et al. [56] | Randomized controlled trial (2006/7) | Rate of X ray based union at 6-12-36 weeks: | No concealed allocation Blinded outcome assessment 80-93% follow-up Underpowered study |
14 PDGF augmented ß-TCP (Augment ®) vs 6 cancellous autologous grafts in 20 adult subtalar, triple, ankle ADs. FU:6, 12 and 36 weeks | |||
PDGF/ß-TCP: | |||
0/11(0%)-5/12(42%)-10/13 | |||
Autologous grafts: | |||
0/4 (0%)-1/3 (33%)-3/5 (60%) | |||
P= ? | |||
Rate of CT based union at 6–12 weeks | |||
PDGF/ß-TCP: | |||
5/13 (38%)-9/13% (69%) | |||
Autologous grafts: | |||
2/5 (40%)- 3/5 (60%) | |||
P= ? | |||