Early Outcomes of 3D Printed Total Talus Arthroplasty

Scott, Daniel J.; Steele, John R.; Fletcher, Amanda N.; Parekh, Selene G.

doi:10.1177/1938640019873536

Cited by 34 publications

(27 citation statements)

References 18 publications

(28 reference statements)

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“…Due to advancements in modern 3D printing and prosthesis casting technology [6], whole talar prostheses have been used for clinical treatment [7][8][9][10], considerably improving the treatment for talus collapse necrosis worldwide. The casting process and surgical indications for the prosthesis are very similar to those used for the conventional method, but the method of prosthesis xation is different.…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Establishment of a Finite Element Model and Biomechanical Analysis of Different Fixation Methods for Total Talar Prosthesis Replacement

Yang¹,

Chang²,

Wan³

et al. 2021

Preprint

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Back ground：A three-dimensional finite element model of the whole foot with high geometric similarity was established and used to simulate the conditions after whole talar prosthesis implantation with several fixation methods, including Screw fixation of subtalar+talus-navicular joint, fixation with screws at only the subtalar joint, and fixation without screws. The biomechanical characteristics of the talus prosthesis were assessed in different gait phases to guide the selection of surgical methods in clinical practice.Methods：With the three-dimensional CT data of a volunteer's foot, Mimics13.0 and Geomagic10.0 software were used to carry out geometric reconstruction of the ankle-related tissues, and Hypermesh10.0 software was used for grid division and material attribute selection. Finally, the data were imported into Abaqus 6.9, and the simulated screw data were applied to different models. Finite element models with different fixation methods were simulated, and the stresses exerted by the human body in three gait phases (heel-strike, midstance and push-off) were simulated. The pressure changes in the articular surface around the talus or the prosthesis, the micromotion of the talus and the prosthesis and ankle motion were measured. Results：Finite element analysis on the biomechanical mechanism showed that screw fixation of the prosthesis in different gait phases mainly increases the pressure on the tibialis articular surface as well as decreases the pressure on the fused articular surface and joint micromotion, which hinders ankle motion. The indicator values were nearly the same in the models of fixation without screws and the normal state.Conclusion：The 3D finite element model created in this study has been verified to be an accurate and reliable model. The biomechanical mechanism varies by fixation method according to finite element analysis. Fixation of the prosthesis without screws yields values most similar to normal values.

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Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Establishment of a Finite Element Model and Biomechanical Analysis of Different Fixation Methods for Total Talar Prosthesis Replacement

Yang¹,

Chang²,

Wan³

et al. 2021

Preprint

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show abstract

“…Considering the newly published study about 3D-printed custom talar prothesis by Rishin J. Kadakia [28,29], this study is quite different. The concrete differences are as follows: (1) different casting methods of prostheses, each adjacent joint surface of the prosthesis has been specially treated; there is also the difference between the bioactive 3D-printed personalized talus prosthesis and the traditional 3D-printed talus prosthesis.…”

Section: Discussionmentioning

confidence: 91%

“…We hypothesized that it is the reason why patients can recover ankle joint activity. In addition, unlike Scott's [29] study, we only used the AOFAS score instead of FAOS score. Compared with AOFAS, FAOS pays more attention to the subjective feelings of patients.…”

Section: Discussionmentioning

confidence: 99%

Three dimension printing talar prostheses for total replacement in talar necrosis and collapse

Yang

Chen

et al. 2021

International Orthopaedics (SICOT)

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Background Reconstructing bone structures and stabilizing adjacent joints are clinical challenges in treating talar necrosis and collapse (TNC). 3D printing technology has been demonstrated to improve the accuracy of talar replacement. This study aimed to evaluate anatomical talar replacement and the clinical results. Methods Nine patients with TNC were enrolled between 2016 and 2020. The prosthetic shape and size were designed by CT post-processing and mirror symmetry technology. The clinical outcomes included radiographic parameters of the forefoot, hindfoot, and ankle alignment, ankle activity, recurrent pain, and peri-operative complications. Results After a mean follow-up of 23.17 ± 6.65 months, degenerative arthritis and prosthetic dislocation and other complications were not observed on plain radiographs. Each 3D-printed talar prosthesis was placed in the original anatomical position. The parameters which have significant changes pre-operative and post-operative are as follows: talar height, 27.59 ± 5.99 mm and 34.56 ± 3.54 mm (95% CI − 13.05 to − 0.87, t = 2.94, P = 0.032) and Meary’s angle, 11.73 ± 4.79° and 4.45 ± 1.82° (95% CI 1.29~22.44, t = 2.89, P = 0.034). The AOFAS hindfoot score improved from 26.33 ± 6.62 to 79.67 ± 3.14 at the final follow-up (95% CI 43.36~63.30, t = 13.75, P = 0.000). The VAS score decreased from 6.33 ± 1.03 to 0.83 ± 0.75 (95% CI 4.40~6.60, t = 12.84, P = 0.000). The post-operative satisfaction scores regarding pain relief, activities of daily living, and return to recreational activities were good to excellent, and the change of activity range was statistically significant. Conclusions The 3D printing patient-specific total talar prostheses allowed anatomical reconstruction in TNC. This novel treatment with 3D-printed prostheses could serve as a reliable patient-specific alternative in TNC.

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“…For example, a 3D-printed total talus replacement may be the best option for those patients with symptomatic talar avascular necrosis who wish to maintain a range of motion in their ankle joint that would allow them to live a relatively active lifestyle after the operation. 11,12 3D-printed procedures in the foot and ankle have been associated with low complication rates and significantly improved Visual Analog Scale (VAS) and Foot and Ankle Outcome Score (FAOS) scores, allowing patients to meet or exceed expectations of returning to their activities of daily living. 11,12…”

Section: Initial Clinical Encountermentioning

confidence: 99%

“…Most of the available literature on 3D printing in orthopaedic surgery is limited to the description of the operative technique and preliminary outcome measures. 2,8-13 There are not many surgeons who routinely apply this technology; this is partly a result of its learning curve and an absence of standardization surrounding 3D printing. When considering that this innovation has consistently led to decreased operative time, improved precision, and enhanced osseointegration, it becomes imperative to elucidate the entire progression of incorporating 3D printing into one’s practice with great clarity and detail.…”

Section: Introductionmentioning

confidence: 99%

Incorporating 3D Printing Into Your Practice: Lessons Learned

Sharma

Kirkland

Holloway

et al. 2020

Foot & Ankle Specialist

Self Cite

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Three-dimensional (3D) printing has greatly benefited medicine, manufacturing vital organs like skin, hearts, kidneys, and livers. Early studies on 3D printing in surgery have consistently reported decreased operative time and improved precision. This technology has gained popularity with orthopaedic surgeons in knee, hip, and shoulder surgeries because 3D printing is associated with enhancing osseointegration. However, this innovation is still not commonly used among foot and ankle surgeons; one reason is that whereas the literature on 3D printing–assisted surgery is populated with studies on operative techniques and clinical outcomes, there exists an ambiguity on how to incorporate this feature into the clinic. Thus, the aim of this technology column is to consolidate and standardize a workflow to guide foot and ankle surgeons on integrating 3D printing into one’s practice. We describe a model developed by a single surgeon at one institution who directs a large caseload of 3D-printed foot and ankle surgeries. From the initial patient visit to the interaction between the surgeon and the implant engineering team, to documentation of data adding to the preliminary literature, this work has great implications on streamlining the assimilation of a highly successful technology to improve foot and ankle surgery for both surgeons and patients. Level of Evidence: Level V

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Early Outcomes of 3D Printed Total Talus Arthroplasty

Cited by 34 publications

References 18 publications

WITHDRAWN: Establishment of a Finite Element Model and Biomechanical Analysis of Different Fixation Methods for Total Talar Prosthesis Replacement

WITHDRAWN: Establishment of a Finite Element Model and Biomechanical Analysis of Different Fixation Methods for Total Talar Prosthesis Replacement

Three dimension printing talar prostheses for total replacement in talar necrosis and collapse

Incorporating 3D Printing Into Your Practice: Lessons Learned

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