Anatomic total talar prosthesis replacement surgery and ankle arthroplasty: an early case series in Thailand

Abstract

Little is known about specific outcomes and early experiences of total talar prosthesis replacement surgery in the current literature, and ankle arthroplasty in Southeast Asia. This study reported on four patients with talar loss or ankle arthritis. Patients were treated with a custom total talar prosthesis (anatomic-metallic version) replacement (TPR, n=1) or with total ankle replacement (TAR, n=3). Baseline data, including Visual-Analog-Scale Foot and Ankle (VAS-FA) and Quality of Life scores via Short-Form-36 (SF-36), were collected for all patients. Mean follow-up time was 7.6 months. From preoperative to postoperative, VAS-FA score increased from 6.0 to 57.5, and SF-36 score increased from 19.3 to 73.7 in a patient with TPR. Mean VAS-FA scores increased from 51.5±15.6 to 85.7±4.7 (P=0.032), and mean SF-36 scores tended to increase from 65.2±13.3 to 99.3±1.2 (P=0.055) in TAR group. This study is the first report of anatomic-metallic TPR which appears to provide satisfactory outcomes for treatment of talar loss at a short-term follow-up. TAR also provides acceptable results for treatment of ankle arthritis at this point.

Morphometric geometric differences between right and left human tali: A cadaveric study of fluctuating asymmetry via systematic measurement and three-dimensional scanning

“…Several ligaments attach the talus to its surrounding articular structures [12]. Based on these exclusive characteristics, the talus is prone to several pathologies and injuries, but the native talus is difficult to reconstruct or duplicate in patients with conditions such as peritalar instability [13], talar bone damage [14], and loss of the talus [2]. Several reports have proposed the characteristics of the talus in terms of its biomechanical and morphologic aspects.…”

“…Knowledge and technology in the field of foot and ankle surgery have progressed rapidly in recent decades. This is evident by the advances in total ankle replacement surgery [1], replacement surgery using total artificial tali [2], and arthroscopic surgery [3]. Such substantial technological progress in foot and ankle surgery has been made possible by the knowledge gained from morphological research in technologies such as computed tomography (CT) [4], threedimensional (3D) printing technology [5], and computer-aided design programs, which transform CT images into 3D images [2].…”

“…This is evident by the advances in total ankle replacement surgery [1], replacement surgery using total artificial tali [2], and arthroscopic surgery [3]. Such substantial technological progress in foot and ankle surgery has been made possible by the knowledge gained from morphological research in technologies such as computed tomography (CT) [4], threedimensional (3D) printing technology [5], and computer-aided design programs, which transform CT images into 3D images [2]. These advanced technologies have led to developments in cutting-edge orthopedic surgery, such as the successful use of patient-specific 3D-printed titanium implants for the treatment of complex large bony defects and deformities and for use in arthrodesis procedures [5].…”

“…These advanced technologies have led to developments in cutting-edge orthopedic surgery, such as the successful use of patient-specific 3D-printed titanium implants for the treatment of complex large bony defects and deformities and for use in arthrodesis procedures [5]. Prostheses have also been created to replace damaged or missing original bone [2], [6]. One of these advances is the development of the total talar prosthesis or customized total ankle prosthesis.…”

“…One of these advances is the development of the total talar prosthesis or customized total ankle prosthesis. The size and shape of the total talar prosthesis is designed based on the contralateral talus [2]. According to Zaidi, human bodies show both anatomical and functional asymmetries, some of which are of great clinical significance.…”