Clinical and Radiological Results after Use of A Human Bone Graft (Shark Screw®) in TMT II/+II Arthrodesis

CATEGORY: Basic Sciences/Biologics; Midfoot/Forefoot; Trauma INTRODUCTION/PURPOSE: The tarsometatarsal joints, also called Lisfranc-joints, are the joints between the midfoot bones and the tarsal bones. The continuous arthrotic destruction of the tarsometatarsal joints leads to pain and foot deformities. The therapy of choice after failure of conservative therapy is arthrodesis. For this operation there is the possibility of using a transplant screw made of allogenic human bone material (Shark Screw), instead of conventional metal implants. This study investigates the clinical significance and radiological integration of the allogenic bone screw for arthrodesis of the tarsometatarsal joints II/+III. METHODS: This is a retrospective study involving 20 feet of 17 patients who received TMT II/+III arthrodesis with an allogenic bone screw (Shark Screw) at Speising Orthopedic Hospital in Vienna, Austria. VAS, FFI, FAOS, and AOFAS were used as measures to compare preoperative and postoperative results. Radiologic integration in the recipient bone was also evaluated. RESULTS: Comparing preoperative with the postoperative score of 20 feet from 17 patients, a significant reduction of the VAS (pain) from 7,6 points to 1,4 points (p=<0,001)), as well as a decrease of the VAS (function) from 7,25 points to 1,8 points has been observed. Further, a significant reduction of the FFI from 62,3% to 16,7% (p=<0,001), and a significant increase from 29,7 points to 79,9 points of the AOFAS (p=<0,001) was detected. Analyzing the FAOS score, there was a significant (p=<0,001) increase of all subscales (Symptoms, Pain, Function and Quality of life). Moreover, in all cases a good radiological integration into the recieverbone was noticed. As a result the screw was, after a follow-up time from 12 months, no longer distinguishable from the original bone. CONCLUSION: These results demonstrated that the human bone screw used for TMT II/+III arthrodesis has a good outcome and reliable clinical significance. This study may be used for further investigations that should be performed to ensure this result.