Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2020; 11(3): 145-157
Published online Mar 18, 2020. doi: 10.5312/wjo.v11.i3.145
Distraction arthroplasty in osteoarthritis of the foot and ankle
Sherif Dabash, Joshua R Buksbaum, Austin Fragomen, S Robert Rozbruch
Sherif Dabash, Austin Fragomen, S Robert Rozbruch, Limb Lengthening and Complex Reconstruction Service, Weill Cornell Medical College Department of Orthopaedic Surgery, Hospital for Special Surgery New York, NY 10021, United States
Joshua R Buksbaum, SUNY Downstate Health Sciences University, College of Medicine, Brooklyn, New York, NY 11226, United States
Author contributions: Dabash S designed the research, performed the research, wrote the paper; Buksbaum JR performed the research and helped in writing the paper; Fragomen A and Rozbruch SR helped in designing the research.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Sherif Dabash, MD, Limb Lengthening and Complex Deformity correction Clinical Fellow, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, United States.
Received: October 24, 2019
Peer-review started: October 24, 2019
First decision: December 17, 2019
Revised: December 22, 2019
Accepted: March 1, 2020
Article in press: March 1, 2020
Published online: March 18, 2020

Post-traumatic osteoarthritis (PTOA) is a complex and painful problem in the foot and ankle. Ninety percent of osteoarthritis cases in the foot and ankle can be classified as post-traumatic. PTOA can affect any of the 33 joints in the foot and the ankle. Distraction arthroplasty is a method for treatment of early arthritic joints without fusing or replacing them and its effectiveness has been well documented. The purpose of this case series is to present our successful experiences and positive results using distraction arthroplasty to treat PTOA in the ankle, subtalar, first metatarsophalangeal, and second tarsometatarsal joints, and to present distraction arthroplasty as a viable alternative to invasive joint sacrificing procedures such as arthrodesis or arthroplasty. Distraction Arthroplasty effectively and safely treats PTOA and improves the stability of joints in the Foot and Ankle. Additionally, the use of bone marrow aspirate concentrate as an adjuvant can improve the long-term functional and structural outcomes of the joint, and can prolong the need for further, more aggressive surgical interventions such as fusion or arthroplasty.

Keywords: Distraction arthroplasty, First metatarso-phalangeal joint arthritis, Second tarsometarsal joint arthritis, Ankle arthritis, Subtalar arthritis, Post-traumatic osteoarthritis

Core tip: Osteoarthritis is a degenerative condition affecting articular joints causing loss of mobility and independence due to pain and swelling in the affected joint. Ninety percent of osteoarthritis cases in the foot and ankle can be classified as post-traumatic and can affect any of the 33 joints in the foot and ankle. Distraction arthroplasty is a viable and effective treatment for Post-traumatic osteoarthritis in the foot and ankle joints, which can prolong the integrity of the joints and prevent a joint sacrificing procedure such as arthrodesis or arthroplasty.