Table 1

Studies comparing structural autologous bone grafts with substitutes in hindfoot arthrodeses and osteotomies
Ref. Methodology Results Quality
Structural allografts versus cortical autologous grafts in hindfoot OTs
Dolan et al. [51] Randomized controlled trial Rate of union at 8 weeks No concealed allocation No blinded outcome assessment 100% FU Underpowered study
18 freeze-dried structural allografts vs. 15 cortical autologus grafts in 31 adults undergoing Evan’s OTs. FU: 8 and 12 weeks Allografts: 17/18 (94%)
Autologous grafts: 9/15 (60%), P = 0.03
Rate of union at 12 weeks
100% for allografts and autologous grafts
No graft collapse in both groups
Templin et al. [52] Retrospective comparative chart review (1994–2003) Rate of union Selection: ***
Allografts: 27/30 (90%) Comparability:
30 freeze-dried structural allografts vs 5 structural autologous grafts in 35 children undergoing Evan’s OTs. Mean FU 3.6 years (range 6–12 years) Autologous grafts: 4/5 (80%) Outcome: *
P = n. s.
Kwak et al. [53] Retrospective comparative chart review (2000–2005) Talo-1st metatarsal, talo-calcaneal and calcaneal pitch angle at final FU Selection: ***
Comparability:
118 acellular allografts (Tutoplast ®) vs. 10 structural autologous grafts in 79 children undergoing Evan’s OTs. Mean FU 15 months (range 13-21months) No significant difference between the two graft types Outcome: *
Structural allografts versus cortical autologous grafts in hindfoot ADs
Easley et al. [4] Subgroup comparison in a retrospective chart review (1988–1995) Rate of union Selection: ***
Allografts: 2/5 (40%) Comparability:
5 structural allografts vs. 29 structural autologous grafts in isolated subtalar ADs. Mean FU 51 months (range 24–130 months) Autologous grafts: 24/29 (83%) Outcome: *
P = n.s.
Time to union
Autologous grafts: 16 weeks (10-30 weeks)
P = n. s.
Structural allografts versus cortical autologous grafts in miscellaneous procedures (hindfoot ADs/OTs)
Grier et al.[54] Retrospective comparative chart review (1996–2006) Rate of union Selection: **
Allografts + PRP: 29/31 (94%) Comparability:
31 structural freeze-dried allografts + PRP vs. 20 structural autologous grafts in 18 adult Evan’s OTs and 33 adult CC ADs. Mean FU: 20 months (range 3-72 months) Autologous grafts: 14/20 (70%) Outcome: *
P = 0.045
Improvement of the talo-1st metatarsal and calcaneal pitch angle
No significant difference between the two graft types
Danko et al. [17] Retrospective comparative chart review (1990–1992) Graft collapse Selection: ***
Evan’s OT: Comparability:
7 structural allografts vs 33 structural autologous grafts in 69 pediatric Evan’s OTs and 61 pediatric CC ADs. Mean FU 2.5 years (range 0.6-7.8 years) Allografts: 0/39 Outcome: ***
Autologous grafts 0/30
P = ?
CC ADs:
Allografts: 17/58 (29%)
Autologous grafts: 0/3 (0%)
P = ?
Mahan et al.[55] Retrospective comparative chart review (1977–1990) Rate of union Selection: **
Allografts: 198/215 Comparability:
215 freeze dried allografts vs 85 autologous grafts in 153 OTs, 55 ADs, 82 other procedures. Minimum FU 6 weeks (92%) Outcome: *
Autologous grafts: 78 /85 (92%),
P = n. s.
Rate of delayed union
Allografts: 8/215 (4%)
Autologous grafts 2/85 (2%)
P = n. s.

Abbreviations: CC=calcaneocuboideal, OTs= osteotomies, ADs= arthrodeses, FU = follow-up, n.s.= not significant.

Müller et al.

Müller et al. BMC Musculoskeletal Disorders 2013 14:59   doi:10.1186/1471-2474-14-59

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