Name: Medial Malleolus Stress Fracture Augmented With ArthroCell™ Bone Graft
Uploaded: 2020-10-08T00:00:00Z
Channel: Arthrex
Description: Ryan B. Rigby, DPM (Logan, UT), demonstrates the treatment of a medial malleolus stress fracture augmented with ArthroCell™ viable cellular bone allograft.

<p>Ryan B. Rigby, DPM (Logan, UT), demonstrates the treatment of a medial malleolus stress fracture augmented with ArthroCell™ viable cellular bone allograft.</p>

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VID1-000941-en-US | A | Medial Malleolus Stress Fracture Augmented With ArthroCell™ Bone Graft

Ryan B. Rigby

Human

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Medial Malleolus Stress Fracture Augmented With ArthroCell™ Bone Graft

Hello, I'm Ryan Rigby from Logan, Utah. I'm presenting a case of a medial malleolus stress fracture in an athlete augmented with ArthroCell. This is a Division one gymnast that had complained of ankle pain for about nine months, and it just kept worsening. We checked her vitamin D level. It was low, so we placed her on supplementation. But looking for an underlying etiology. You do see on the anterior part of her ankle, she's developed an osteophyte a large deformity in this area. And you think about gymnasts. They have a lot of dorsiflexion when they're performing their particular sport. And this has led to overload of the medial aspect of leading to this stress fracture that you see here. And if you get a CT, you identify the stress fractures coming from anterior to posterior. And this does appear to be chronic. There's buildup of bone along the anterior edge indicating that this has been happening for quite a while. It's vital that we address the underlying etiology. So I took the patient and cleaned out the anterior portion of the ankle, performed an anterior arthroplasty, and then to address the lesion that had developed, I performed a debridement, cleaned the area of any sclerotic tissue, fibrotic tissue that had formed. And then I incorporated this augmented this with ArthroCell. I used this because ArthroCell provides the full triad of bone healing. It brings the scaffold, it brings the signal and the cells. This has a high concentration of osteoprogenitor cells. And not only that, I'm able to pack this into a lesion like this very well. And then it stays in into the area that you've packed it in afterwards and just delivers a lot of biologic healing potential. Those osteoprogenitor cells can go to work and heal this fracture, or this area that has struggled to heal for a long time. It's important that we apply compression across a chronic fracture like this. I use two compression screws from medial to lateral, and here's her final post-op x ray showing the area had completely healed and resolved, and she was able to return back to gymnastics. So in summary malleolus stress fractures. When dealing with these, it is very important that we look for, identify and then address the underlying etiology for a good long term success, whether that's instability or impingement like this case or cavus, etc.. Check vitamin D that plays a role in healing, but more than anything, incorporate biologics. Arthrocell provided an excellent source of biologics to facilitate healing for this particular patient. Thank you.

Medial Malleolus Stress Fracture Augmented With ArthroCell™ Bone Graft

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