TY - JOUR AU - Silveira, Gil Galvão Bernardes AU - Castro Junior, Isnar Moreira AU - Mansur, Henrique AU - Morgado, Guilherme Ferreira PY - 2019/03/31 Y2 - 2024/03/29 TI - Subtalar arthrodesis with bone graft. Is it needed for smokers? JF - Scientific Journal of the Foot & Ankle JA - Sci J Foot Ankle VL - 13 IS - 1 SE - Original Articles DO - 10.30795/scijfootankle.2019.v13.905 UR - https://jfootankle.com/ScientificJournalFootAnkle/article/view/905 SP - 49-54 AB - <p><strong>Objective</strong>: To evaluate the union rate of subtalar arthrodesis in smokers and nonsmokers and effect of the use of different types of autologous bone grafts.&nbsp;<strong>Methods</strong>: This was a retrospective study with radiological evaluation of patients with subtalar arthrosis who underwent primary arthrodesis at a reference hospital between January 2008 and December 2014. Patients with a minimum follow-up period of 12 months were included and were divided into smokers and nonsmokers with or without autologous bone grafting.&nbsp;<strong>Results</strong>: In total, 235 patients with a mean age of 47 years (range: 19-74 years) were evaluated, among whom 90 (40%) were smokers and 141 (60%) were nonsmokers. In 221 (94%) cases, the indication for arthrodesis was due to sequelae of calcaneal fractures. A bone graft was used in 65 (27.7%) patients. The overall union rate was 85.4%, and 14.6% of the patients progressed to pseudoarthrosis. A statistically significant difference was found in the nonunion rate in smokers (p-value=0.015 by chi-square test), especially in those who did not receive a bone graft (p-value=0.014 by chi-square test). However, no significant difference was found between smokers who received a bone graft and those who did not (p-value=0.072 by chi-square test). The union rate was related to the donor site, with pseudoarthrosis in 33.3% of surgeries with an autologous calcaneal bone graft (p-value=0.011).&nbsp;<strong>Conclusion</strong>: Smoking increased the likelihood of pseudoarthrosis in subtalar arthrodesis by 2.5-fold, and pseudoarthrosis is related to the autologous bone graft donor site.&nbsp;<em><strong>Level of Evidence III; Therapeutic studies; Comparative Retrospective Study.&nbsp;</strong></em></p> ER -