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Effects of teriparatide on fusion rates in patients undergoing complex foot and ankle arthrodesis
Institution:1. Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, South Korea;2. Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, South Korea;3. Department of Orthopaedic Surgery, Veterans Health Service Medical Center, South Korea;1. Department of Orthopaedics, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;2. Department of Orthopaedics, Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland;3. Department of Clinical Research, University Hospital Basel, Spitalstrasse 12, 4031 Basel, Switzerland;4. Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA;1. Technical University Munich, Klinikum rechts der Isar, Department of Orthopedics and Sports Orthopedics, Ismaninger Str. 22, 81675 Munich, Germany;2. Schön Klinik München Harlaching, Fachzentrum für Fuß- und Sprunggelenkchirurgie, Harlachinger Str. 51, 81547 Munich, Germany;3. Orthopädie Zentrum Arabellapark OZA, Englschalkinger Str. 12, 81925 Munich, Germany;4. Klinik für Allgemeine?, Unfall- und Wiederherstellungschirurigie, Klinikum der Universität München, LMU München, München, Deutschland;1. Orthopaedic Hospital for Children, Behandlungszentrum Aschau gGmbH, Bernauer str. 18, 83229 Aschau i. Chiemgau, Germany;2. Bismarckstr. 60, 69198 Schriesheim, Germany;3. Friedrich-Alexander-University of Erlangen-Nürnberg, Department of Orthopaedic Surgery Rathsberger str. 57, 91054 Erlangen, Germany;1. Case Western Reserve University School of Medicine, 2901 Adelbert Road, Cleveland, OH 44106, USA;2. Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA;3. Division of Pediatric Orthopaedic Surgery, Rainbow Babies and Children’s Hospital at University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA;1. School of Nursing, University of Rochester, 255 Crittenden Blvd, Rochester, NY 14642, USA;2. Department of Orthopaedics, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA;3. School of Health Science and Human Performance, Movement Analysis Laboratory, Ithaca College, 953 Danby Road, Ithaca, NY 14850, USA;4. Department of Orthopaedics, Director of Sub-Internship and Medical Student Education, Director of Musculoskeletal Curriculum, University of Rochester School of Medicine and Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA
Abstract:BackgroundHere, we determined whether teriparatide treatment would increase fusion rates after foot and ankle arthrodesis by comparing treatment results between patients with high-risk factors for nonunion who received teriparatide against those who did not.MethodsWe retrospectively reviewed 66 consecutive patients who underwent foot and ankle arthrodesis. The inclusion criterion was the presence of at least one of the following risk factors for nonunion after previous foot and ankle arthrodesis: deformity, bone defects, avascular necrosis, and nonunion. Sixteen patients were finally enrolled and divided into 2 groups: 8 patients received teriparatide treatment after fusion surgery (PTH group), and 8 patients did not (control group).ResultsThe fusion rate was significantly greater in the PTH group than in the control group (100% vs 50%). Four patients in the control group developed nonunion, 3 of whom underwent revision fusion; however, all patients received the teriparatide treatment after revision surgery and subsequently achieved union. No significant differences in demographics, fusion sites, and complication rates were found.ConclusionThough the sample size was small, the current study suggests that teriparatide administration may improve fusion rates in patients with high-risk factors for nonunion after foot and ankle arthrodesis.
Keywords:Teriparatide  Foot  Ankle  Arthrodesis  Fusion  Nonunion
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