Orthobiologics in Foot and Ankle Surgery
Orthobiologics in Foot and Ankle Surgery
It is well accepted that diabetics have a higher complication rate associated with impaired wound and osseous fracture surgery, which leads to an increased risk for delayed or nonunion. When growth factor levels were measured within a closed fracture hematoma, the levels of several key growth factors were significantly decreased, which correlated with a greater potential to progress to nonunion. Those diabetic patients who develop a nonunion after attempted elective arthrodesis in the foot and ankle, have been demonstrated to have decreased levels of VEGF and PDGF. This once again begs the question whether there are critical levels of key growth factors necessary to support successful bony union at the time of an index operation and whether the addition of growth factor has the potential to increase the chance of successful bony union.
Diabetic Fracture Healing
It is well accepted that diabetics have a higher complication rate associated with impaired wound and osseous fracture surgery, which leads to an increased risk for delayed or nonunion. When growth factor levels were measured within a closed fracture hematoma, the levels of several key growth factors were significantly decreased, which correlated with a greater potential to progress to nonunion. Those diabetic patients who develop a nonunion after attempted elective arthrodesis in the foot and ankle, have been demonstrated to have decreased levels of VEGF and PDGF. This once again begs the question whether there are critical levels of key growth factors necessary to support successful bony union at the time of an index operation and whether the addition of growth factor has the potential to increase the chance of successful bony union.
