Use of structural allograft to compensate for bone loss in arthrodesis of the foot and ankle.

Allografts have several important advantages over other forms of bone graft augmentation. In addition to preventing the morbidity of autogenous bone graft harvesting, the quantity of allograft bone is essentially unlimited and is therefore valuable for use in treating very large defects that exceed the yield of the iliac crest. Allografts are particularly helpful in obese patients or patients with systemic disease because the they has the potential to reduce blood loss and anesthesia time. Regional anesthesia with either an ankle or a spinal block may be safer for the rheumatoid patient with cervical instability. In addition, the use of an allograft makes it possible to do many foot and ankle fusions as outpatient procedures, whereas it is commonly necessary to hospitalize patients who have bone graft harvested from the iliac crest. Like the findings of other authors, our experience suggests that structural allograft is an attractive alternative in reconstructive surgery and in arthrodesis of the foot and ankle and is a valuable part of the surgeon's armamentarium.