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Subtalar Arthrodesis: Study on Bone Grafting in Collaboration with Villa Stuart

Article Contents

New publication by Dr. Fabrizio Forconi in the Journal of Foot and Ankle Research on a multicenter study conducted with other specialists that analyzed the effectiveness of bone grafting in subtalar arthrodesis procedures. The research demonstrates that, with proper alignment, excellent healing rates (90.9%) can be achieved even without the use of grafts.

Background

This study aimed to compare the clinical and radiographic outcomes of subtalar arthrodesis performed with and without bone grafting and to evaluate the influence of different types of grafts on fusion and functional results.

Methodology

A multicenter retrospective observational study was conducted, including 66 patients who underwent isolated subtalar joint arthrodesis (SJA) between 2023 and 2025. Patients were divided into a group with bone grafting (n = 51) and a group without grafting (n = 15). A subgroup analysis compared autologous, fresh-frozen allogeneic, and commercial allogeneic grafts.

The evaluated outcomes included bone fusion, time to fusion, complications, and functional scores (AOFAS, FAAM-ADL, and FAAM-Sports). Multivariable regression analyses and ROC curves were also performed to identify independent predictors of nonunion and delayed bone healing.

Results

Overall, the bone healing rate was 90.9%. Fusion was achieved in 92.2% of patients treated with bone grafting and in 86.7% of patients without grafting (p = 0.612). In adjusted exploratory analyses, the use of bone grafting was not independently associated with fusion, complications, or healing time. Increased age and body mass index (BMI) were found to be independently associated with prolonged healing time.

ROC analysis identified an age ≥ 60 years as a predictor of nonunion (AUC 0.782), while an age ≥ 59 years and a BMI ≥ 25.9 kg/m² were predictors of delayed healing. Both groups showed significant postoperative improvement in all evaluated functional scores (all p 0.001).

The use of autologous grafting was associated with higher postoperative functional scores; however, this finding should be interpreted with caution due to possible baseline differences between groups and potential selection bias.

Full Publication

For the full research: https://onlinelibrary.wiley.com/doi/10.1002/jfa2.70160

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