Effect analysis of iliac bone autografting for Hepple V osteochondral lesions of the talus

Background Talar cartilage injury is a kind of disease that causes long-term and chronic pain of ankle joint. Autologous osteochondral transplantation has been viewed as an alternative choice for treating these lesions, but donor-site morbidity has limited its application. This study aimed to analyze the efficacy of iliac bone autografting for Hepple V osteochondral lesions of the talus. Methods This retrospective study included 32 patients surgically treated for Hepple V osteochondral lesions of the talus from January 2015 to January 2020. All patients underwent open surgery. Ipsilateral iliac bone grafts were taken and filled with talar cartilage injury area. The improvement of postoperative ankle pain was evaluated by Visual Analogue Scale (VAS), and the improvement of ankle function was evaluated by the American Orthopaedic Foot & Ankle Society (AOFAS). During the postoperative follow-up, X-ray examination of the front and side of the ankle joint and CT of the ankle joint were performed to evaluate the bone cartilage healing in the graft area. Results Thirty-two patients (32 ankles) (100%) returned for clinical and radiologic follow-up at an average of 28 (range 24–36) months postoperatively. At 3 months postoperatively and at the last follow-up, the AOFAS scores were (80.4 ± 3.6) and (89.2 ± 6.4), respectively, which were significantly improved compared with the preoperative score (49.7 ± 8.1), and the difference was statistically significant (P < 0.05). The VAS scores were (2.1 ± 0.9) and (1.5 ± 0.8), respectively, which were significantly better than the preoperative score (6.2 ± 1.7), and the difference was statistically significant (P < 0.05). Re-examination of the front and side of the ankle joint X-rays and CT showed that the bone healing at the osteotomy of medial malleolus and osteochondral transplantation area. All patients had no pain at the donor site. No complications occurred in 32 patients at the last follow-up. Conclusions With iliac bone autografting for Hepple V osteochondral lesions of the talus can effectively relieve ankle joint pain and significantly improved ankle function. Level of evidence Level III, Retrospective series.

Comparison of C2-3 Pedicle Screw Fixation With C2 Spinous Muscle Complex and Iliac Bone Graft for Instable Hangman Fracture

Purpose: To compare the effect between C2 spinous muscle complex graft and iliac bone graft in C2-3 pedicle screw fixation for instable Hangman fracture. Using axial spinous muscle complex instead of iliac bone for instable Hangman fracture can decrease neck pain, bone donor site complication, and operation time.Method: The outcomes of C2-3 pedicle screw fixation with C2 spinous muscle complex were compared with iliac bone graft in 18 and 21 patients with instable Hangman fracture. The mean age was 49.1 ± 15.8 years in the complex group and 55.3 ± 12.2 years in the Iliac group, and the mean time to surgery of the patients was 3.3 ± 0.6 days in the complex group and 3.6 ± 0.9 days in the iliac group. Outcome measures including operation time, blood loss, visual analog scale (VAS) for pain, Japanese orthopedic association score (JOA), American spine injure association classification (ASIA), and bone fusion time were collected from medical records. In addition, the postoperative complications were also recorded.Results: There were significant differences in operation time and interoperative blood loss between the two groups (P &lt; 0.01). Also a significant difference was found in VAS score and JOA score between the two groups (P = 0.0012 and P &lt; 0.001, respectively) at 1-month follow-up, whereas, no significant difference was found at other visit time. In the final visit, all patients showed good bone fusion, and two patients shows incision edema and exudation in the iliac group.Conclusion: C2-3 pedicle screw fixation with C2 spinous muscle complex graft maybe a feasible and safe procedure for instable Hangman fracture.

Possibility of Using Flexible Dentures over Iliac Bone Graft in Adolescent Patients with Ameloblastoma: A 9-Month Follow-Up Clinical Report

Introduction. The use of bone grafts is a common procedure after excision and reconstruction of the mandible, although it is rare in children and adolescents due to incomplete growth, which means a long transition period until reaching an appropriate age for implants or more predictable outcomes. Case Report. This article describes a 9-month follow-up of the use of a flexible denture above a bone graft taken from the anterior iliac crest for adolescent patients with resected mandible due to ameloblastoma. Taking into account prosthetic considerations, radiography, and clinical observation, no complications were seen with the graft. Conclusion. It is safe to use a flexible denture as a prosthetic over an iliac bone graft block during the healing period.

Effect Analysis of Iliac Bone Autografting for Hepple V Osteochondral Lesions of The Talus

BackgroundThis study aimed to analyze the efficacy of iliac bone autografting for Hepple V osteochondral lesions of the talus.MethodsThis retrospective study included 32 patients surgically treated for Hepple V osteochondral lesions of the talus from January 2015 to January 2020. All patients underwent open surgery. Ipsilateral iliac bone grafts were taken and filled with talar cartilage injury area. The improvement of postoperative ankle pain was evaluated by Visual Analogue Scale (VAS), and the improvement of ankle function was evaluated by the American Orthopaedic Foot & Ankle Society (AOFAS). During the postoperative follow-up, X-ray examination of the front and side of the ankle joint and CT of the ankle joint were performed to evaluate the bone cartilage healing in the graft area.ResultsThirty-two patients (32 ankles) (100%) returned for clinical and radiologic follow-up at an average of 28 (range, 24–36) months postoperatively. At 3 months postoperatively and at the last follow-up, the AOFAS scores were (80.4±3.6) and (89.2±6.4) respectively, which were significantly improved compared with the preoperative score (49.7 ± 8.1), and the difference was statistically significant (P<0.05). The VAS scores were (2.1±0.9) and (1.5±0.8) respectively, which were significantly better than the preoperative score (6.2±1.7), and the difference was statistically significant(P < 0.05). Re-examination of the front and side of the ankle joint x-rays and CT showed that the bone bone healing at the osteotomy of medial malleolus and osteochondral transplantation area. All patients had no pain at the donor site. No complications occurred in 32 patients at the last follow-up.ConclusionsWith iliac bone autografting for Hepple V osteochondral lesions of the talus can effectively relieve ankle joint pain and significantly improved ankle function. The clinical effect is remarkable.Level of evidence：Leve III, Retrospective series.

Mixed Mode Crack Propagation in Iliac Bone

Bone is a complex material that can be regarded as an anisotropic elastic composite material. The problem of crack propagation in human bone is analyzed by using a generalization of the maximum tensile stress criterion (MTS). The results concern the critical stress for crack propagation and the direction of the crack path in Iliac bone.