Midfoot Joint Arthrodesis Using Compression Plate With Lag Screw Augmenting With Highly Porous ß-Tricalcium Phosphate and Bone Marrow Aspirate Concentrate.

ABSTRACT

BACKGROUND: There is still a controversy regarding the most optimal fixation instruments and bone graft materials for midfoot joint arthrodesis. We present the results of midfoot joint arthrodesis using compression plate with lag screw augmenting with highly porous ß-tricalcium phosphate (ß-TCP) and bone marrow aspirate concentrate (BMAC). METHODS: We performed a retrospective review of patients undergoing midfoot joint arthrodesis using compression plate with lag screw augmenting with highly porous ß-TCP and BMAC from January 2014 to May 2019. The radiographic bony union rate was investigated. Postoperative complications and reoperations were also reviewed. A total of 36 patients (37 feet) including 75 joints were available in this study. RESULTS: A high union rate was achieved as of 97.3% in 73 of 75 joints. Nonunion occurred in 2 patients including 2 joints. Other than nonunion, there were no major complications such as deep infection. Minor complications (5 of 75 joints, 6.7%) included hardware irritations. Reoperations were required in 1 patient for revision of arthrodesis and symptomatic hardware removal was performed in all 5 hardware irritation cases. CONCLUSION: Based on our results, the fixation construct of compression plate with lag screw augmenting with highly porous ß-TCP and BMAC is safe and effective for midfoot joint arthrodesis with an excellent union rate and a low complication rate. LEVEL OF EVIDENCE IV, retrospective case series.