Bone Graft Substitutes Used in Non-spinal Orthopaedic Arthrodesis Surgery: A Systematic Review.
John MacDonald, Haley Glazebrook, Joel Morash et al.
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In 30 seconds
This systematic review assessed the quantity and quality of clinical outcome evidence for bone graft substitutes (BGS) in non-spinal orthopaedic arthrodesis. Searches of PubMed, Embase, and the Cochrane Library identified 1,751 studies, of which 15 met inclusion criteria. All included studies concerned foot and ankle procedures and covered eight commercially available BGS. Augment had the largest evidence base and received a grade A recommendation; the other BGS received grade I recommendations because published clinical outcome data were insufficient.
Key findings
- Of 1,751 studies identified, 15 met inclusion criteria; all addressed foot and ankle arthrodesis and eight commercially available BGS.
- Augment had the most evidence and received a grade A recommendation.
- All other BGS received grade I recommendations because of insufficient published clinical outcome data.
Why it matters
BGS are used in arthrodesis, but this review found that clinical outcome evidence is limited and uneven across products. The findings help frame how much confidence can be placed in the published evidence when considering these materials, while underscoring that recommendations for most reviewed substitutes remain constrained by a lack of clinical data.
What to keep in mind
Only 15 studies met inclusion criteria, and all concerned foot and ankle arthrodesis, limiting the breadth of the evidence across non-spinal orthopaedic procedures.