Bone autograft collapse. Clinical case of the complication and clinical case of the solutions to this problem

Introduction: The choise of the surgical treatmentof full-layered bone defects of the talar dome is a topical ussie. Mosaicplasty of the talar dome is the «gold standart» in the treatment of patients with full-layered defects of the talus, but this technique also have disadvantages the formation of subxhondral cyst, bone graft collapse.

Clinical cases description: Two clinical cases are presented to your attention, in 1 clinical case performed bone mosaicplasty of the talar dome. After 6 month complication — collapse of the bone autograft, accompanied by pain syndrome. After 6 month ankle fusion was performed. After 6 month pain syndrome was reliefe VAS score decreased from 7 to 3/10 points. AOFAS improved to 74/100 points, FAAM to 70/84 points. In 2 clinical case we taken modified mosacplasty with AMIC (Autologous matrix-induced chondrogenesis) technology, with k-wire provisor bone graft fixation. In the 2 clinical case after 6 month after operation, according to CT: bone grafts osteointegration without sybchondral cyst formation. Good clinical result: VAS decreased from 7/10 to 1/10, AOFAS improved from 70/100 to 90/100 and FAAM improved 72/84 to 83/84 points.

Conclusion: The peading criteries of a good result of chondroplasty of the talar dome is stability of the bone autograft. Stability was achieved by sufficient graft length and stable fixation. The proposed method of k-wire provisor fixation bone graft, in our opinion this method. That allows maintaining the stability of the bone autograft, press-fit contact autograft talus bone.