Tibiotalocalcaneal arthrodesis with distal tibial allograft for massive bone deficits in the ankle

Background The purpose of this study was to assess the outcomes of distal tibial structural allograft to obtain a stable TTC fusion. Methods Retrospectively, ten patients were carried out with a minimum one year follow-up. The median age was 72 (33–81). The median BMI was 28 (24–33). Indications for TTC arthrodesis included failed total ankle arthroplasty (n=7 patients), prior nonunion (n=2 patients), and a trauma injury. Results Union rate was 80%. The median initial height of the distal tibial allograft was 19mm (14–24mm). In seven cases the allograft did not lose height. The AOFAS score median was 69 (31–84). SF-12 median physical component was 39 (30–53), and 59 (23–62) for mental component. The VAS median was 2 (0–8). Conclusions TTC using distal tibial allograft shows a lower rate of collapse than other structural grafts and provides a fusion rate higher or in accordance with the literature. Level of evidence Level IV, retrospective case series.