Background: Fresh osteochondral total ankle allograft transplantation has been reported in the literature with survival rates between 50% and 92% at 1- to 12-years followup. The goal of this study was to present the results of total ankle allografts from another institution.
Materials and methods: Twenty-nine patients underwent osteochondral total ankle transplant at our institution between July 2003 and July 2005. The mean patient age was 41 years old and the mean followup duration was 2 years.
Results: At followup, 14 of the 29 transplants had been revised to a repeat ankle transplant, prosthetic total ankle arthroplasty, or bone block arthrodesis. In addition, 6 of the remaining 15 transplants were deemed to be radiographic failures due to allograft fracture, allograft collapse, or progressive loss of joint space. The remaining 9 allografts (31%) were considered successes. In comparing the success versus the failure group, patients who were older, who had a lower body-mass index, and who had minimal preoperative angular deformity did significantly better.
Conclusion: This is the largest series of osteochondral total ankle allograft transplants reported in the literature to date. There is an extremely high rate of failure associated with this procedure, and we currently consider it only rarely in patients who are too young for ankle replacement, have excellent range of motion, low body mass index, normal radiographic alignment, and who refuse arthrodesis.