Evidence map›Paper›PMID 42121338›Full record

Observational studyJournal of foot and ankle research2026

Impact of Bone Grafting and Graft Type on Fusion and Patient-Reported Outcomes Following Subtalar Arthrodesis: A Multicenter Retrospective Cohort Study.

Giovan Giuseppe Mazzella, Antonio Bove, Andrea De Fazio, Natale Maria Gangemi, Marco Peruzzi, Fabrizio Forconi, Philip Krekosch, Christian Lausmann, Mustafa Citak, Vincenzo Di Sanzo and 2 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Journal of foot and ankle research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Comparative analysis of autograftJournal of spine surgery (Hong Kong) · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Giovan Giuseppe MazzellaDepartment of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.ORCID https://orcid.org/0000-0002-1230-9537
Antonio BoveDepartment of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.ORCID https://orcid.org/0009-0002-5835-5018
Andrea De FazioDepartment of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Natale Maria GangemiMadonna delle Grazie Clinic, Velletri, Rome, Italy.
Marco PeruzziMadonna delle Grazie Clinic, Velletri, Rome, Italy.
Fabrizio ForconiVilla Stuart Sport Clinic, FIFA Medical Center of Excellence, Rome, Italy.
Philip KrekoschDepartment of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany.
Christian LausmannDepartment of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany.
Mustafa CitakDepartment of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany.
Vincenzo Di SanzoMadonna delle Grazie Clinic, Velletri, Rome, Italy.
Giulio MaccauroDepartment of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Raffaele VitielloDepartment of Aging, Orthopaedic and Rheumatological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.ORCID https://orcid.org/0000-0003-2321-9665

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe role of bone grafting in subtalar joint arthrodesis (SJA) remains controversial. This study aimed to compare clinical and radiographic outcomes of SJA performed with and without bone graft and to evaluate the influence of different graft types on fusion and functional results.

methodsA multicenter retrospective observational study was conducted including 66 patients who underwent isolated SJA between 2023 and 2025. Patients were divided into graft (n = 51) and no graft (n = 15) groups. A subgroup analysis compared autologous, fresh frozen allogeneic, and commercial allogeneic grafts. Outcomes included osseous union, time to union, complications, and functional scores (AOFAS, FAAM-ADL, and FAAM-Sports). Multivariable regression and ROC analyses were performed to identify independent predictors of nonunion and delayed union.

resultsOverall, the union rate was 90.9%. Union was achieved in 92.2% of grafted patients and 86.7% of nongrafted patients (p = 0.612). Bone graft use was not independently associated with union, complications, or time to union in the adjusted exploratory analyses. Increasing age and BMI were independently associated with a prolonged time to union. ROC analysis identified age ≥ 60 years as a predictor of nonunion (AUC 0.782) and age ≥ 59 years and BMI ≥ 25.9 kg/m

conclusionsIn isolated SJA performed in a well-aligned hindfoot, high union rates and significant functional improvement were achieved regardless of bone graft use. However, due to the retrospective, nonrandomized design and limited number of nonunion events, no definitive conclusions can be drawn regarding the routine necessity or superiority of bone grafting. Though, bone graft use appeared to be associated with improved functional outcomes in selected higher risk patients, although these findings should be interpreted cautiously given the exploratory nature of the analysis. All subgroup and threshold analyses should be interpreted as exploratory.

Indexed as

ArthrodesisBone TransplantationSubtalar JointAdultAgedFemaleHumansMaleMiddle AgedPatient Reported Outcome MeasuresRetrospective StudiesTreatment Outcome

Identifiers

PMID42121338
PMCPMC13167702

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.