Joint curettage arthrodesis technique in the foot: a histological analysis

J Foot Ankle Surg. 2009 Sep-Oct;48(5):558-64. doi: 10.1053/j.jfas.2009.05.008. Epub 2009 Jul 2.

Abstract

Arthrodesis via joint contour preservation using the curettage method has become popular in foot and ankle surgery to avoid segmental shortening and the need to bone graft. Despite its popularity, the effect of joint curettage has never been histologically evaluated. Knowledge of the histological appearance after joint curettage would be helpful to the foot and ankle surgeon to better understand the function of joint surface preparation for arthrodesis. Five cadaver specimens were used to harvest the first metatarsocuneiform and subtalar joints for routine histological analysis after performing joint curettage technique. One specimen was used as a reference, whereas the remaining specimens were processed after joint surface preparation. Results show a residual layer of calcified cartilage overlying the subchondral plate interface on all osteochondral specimens after joint curettage. This suggests there is a natural histological barrier that may interfere with arthrodesis consolidation.

Level of clinical evidence: 5.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthrodesis / instrumentation
  • Arthrodesis / methods*
  • Cadaver
  • Curettage*
  • Female
  • Foot / anatomy & histology
  • Foot / pathology
  • Foot / surgery*
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures / instrumentation
  • Orthopedic Procedures / methods*