Incorporation of an Allogenic Cortical Bone Graft Following Arthrodesis of the First Metatarsophalangeal Joint in a Patient with Hallux Rigidus

Iva Brcic, Klaus Pastl, Harald Plank, Jasminka Igrec, Jakob Schanda, Eva Pastl, Mathias Werner

Research output: Contribution to journalArticlepeer-review


Hallux rigidus is degenerative arthritis of the first metatarsophalangeal joint characterized by pain and stiffness in the joint with limitation of motion and functional impairment. Recently, bone grafts have been introduced in orthopedic procedures, namely osteosynthesis and arthrodesis. Allografts can induce bone formation, provide support for vascular and bone ingrowth and have a low risk of immunological rejection. A 52-year-old female patient with hallux rigidus underwent arthrodesis of the first metatarsophalangeal joint using Shark Screw® made of allogenic cortical bone. Corrective surgery was performed after 10 weeks, and a 5 × 3 mm large part of the Shark Screw® with the surrounding patient’s bone was removed. A histological evaluation revealed a vascularized graft with the newly formed compact lamellar bone fitting exactly to the cortical graft. The bone surface was lined by plump osteoblasts with osteoid production, and osteocytes were present in the lacunae. The arthrodesis of the first metatarsophalangeal joint using an allogenic cortical bone graft results in fast, primary bone healing without immunological rejection. This case suggests that the cortical allograft is a good and safe treatment option with an excellent graft incorporation into the host bone. However, as the literature evaluating the histology of different bone grafts is scarce, further high-level evidence studies with adequate sample sizes are needed to confirm our findings.

Original languageEnglish
Article number473
Number of pages10
Issue number6
Publication statusPublished - 2021


  • Allogenic
  • Arthrodesis
  • Cortical bone graft
  • Hallux rigidus
  • Screw

ASJC Scopus subject areas

  • Medicine(all)
  • Materials Science(all)
  • Ecology, Evolution, Behavior and Systematics
  • Biochemistry, Genetics and Molecular Biology(all)
  • Palaeontology
  • Space and Planetary Science

Fields of Expertise

  • Human- & Biotechnology
  • Advanced Materials Science

Treatment code (Nähere Zuordnung)

  • Basic - Fundamental (Grundlagenforschung)

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