The Talar Body Prosthesis: Results at Ten to Thirty-six Years of Follow-up

Harnroongroj, Thos; Harnroongroj, Thossart

doi:10.2106/jbjs.m.00377

Cited by 71 publications

(93 citation statements)

References 6 publications

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“…Harnroongroj et al 14,15 introduced a stainless-steel talar body prosthesis designed by slit scanography and reported a postoperative median score of >75 points on the American Orthopaedic Foot & Ankle Society ankle-hindfoot scoring system. In contrast, we developed two models of custom-made artificial talar body implants made of alumina ceramic designed with computed tomography (CT) 16,17 .…”

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confidence: 99%

An Alumina Ceramic Total Talar Prosthesis for Osteonecrosis of the Talus

Taniguchi

Takakura

Tanaka

et al. 2015

The Journal of Bone and Joint Surgery

132

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Background: Treatment of osteonecrosis of the talus is challenging. Total talar replacement has the potential to restore the function of the ankle joint without an associated leg-length discrepancy. The purpose of the present study was to investigate postoperative function and pain after total talar replacement in patients with osteonecrosis of the talus.Methods: Fifty-five ankles in fifty-one consecutive patients with osteonecrosis of the talus who were treated with a total talar replacement from 2005 to 2012 were included in the investigation. Scores according to the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and the Ankle Osteoarthritis Scale (AOS) were assessed before surgery and at the final follow-up evaluation.Results: According to the JSSF ankle-hindfoot scale, the score for pain improved from a mean (and standard deviation) of 15 ± 9.4 points (range, 0 to 20 points) to 34 ± 5.6 points (range, 20 to 40 points); the score for function, from 21.2 ± 9.7 points (range, 4 to 38 points) to 45.1 ± 4.0 points (range, 37 to 50 points); the score for alignment, from 6.0 ± 2.8 points (range, 5 to 10 points) to 9.8 ± 0.9 points (range, 5 to 10 points); and the total score, from 43.1 ± 17.0 points (range, 11 to 68 points) to 89.4 ± 8.4 points (range, 76 to 100 points). According to the AOS scale, the score for "pain at its worst" improved from a mean of 6.1 ± 3.3 points (range, 0 to 9.9 points) to 2.0 ± 1.7 points (range, 0 to 6.3 points).Conclusions: Prosthetic talar replacement is a useful procedure for patients with osteonecrosis of the talus as it maintains ankle function.

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confidence: 99%

An Alumina Ceramic Total Talar Prosthesis for Osteonecrosis of the Talus

Taniguchi

Takakura

Tanaka

et al. 2015

The Journal of Bone and Joint Surgery

132

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“…In a subsequent report on the outcomes of talar body replacement with a metallic prosthesis by Harnroongroj and Harnroongroj [20], satisfactory function of the foot and ankle was observed during 10–36 years of follow-up. Angthong similarly reported that an anatomic metallic prosthesis provided satisfactory short-term follow-up outcomes for traumatic loss of the talus [21].…”

Section: Discussionmentioning

confidence: 99%

Custom-Made Alumina Ceramic Total Talar Prosthesis for Idiopathic Aseptic Necrosis of the Talus: Report of Two Cases

Tonogai

Hamada

Yamasaki

et al. 2017

Case Reports in Orthopedics

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Two women aged 65 years and 78 years presented to our center with idiopathic necrosis of the talus. In both cases, imaging examinations showed collapse and sclerotic changes of the talar body caused by the necrosis. Both women underwent resection and placement of a third-generation custom-made alumina ceramic total talar prosthesis. Immobilization of the ankle in a short-leg cast for 3 weeks was followed by early rehabilitation. One year and 6 months after surgery, both women were able to walk without pain. Their Japanese Society for Surgery of the Foot ankle-hindfoot scale scores improved from 22 and 29/100 points to 90 and 95/100 points, respectively. To the best of our knowledge, the successful treatments of these two rare cases of idiopathic necrosis of the talus are among only a few reported cases of using a third-generation alumina ceramic prosthesis.

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“…Stevens et al[17] even reported on a 14-year-old girl who underwent total talar replacement after an open talar dislocation. And again it was Harnroongroj to report on the largest series of 33 patients with by far the longest follow-up period of 10-36 years after implantation of a talar body prosthesis[15]. In this series published in 2014, 28 of the 33 prostheses were still in place at the time of final follow-up while five had failed prior to five years.…”

Section: Introductionmentioning

confidence: 99%

“…For example, early prosthesis failure occured as a result of size mismatch in two patients in the large series reported by Harnroongroj et al[15]. And according to Ando et al the procedure of total talar replacement carries at least a theoretical risk of anterior instability of the prosthesis, because the anterior talofibular ligament (ATFL) and deep deltoid ligaments are divided during the procedure[16].…”

Section: Introductionmentioning

confidence: 99%

Development of an internally braced prosthesis for total talus replacement

Regauer¹,

Lange²,

Soldan³

et al. 2017

WJO

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Total loss of talus due to trauma or avascular necrosis, for example, still remains to be a major challenge in foot and ankle surgery with severely limited treatment options. Implantation of a custom made total talar prosthesis has shown promising results so far. Most important factors for long time success are degree of congruence of articular surfaces and ligamentous stability of the ankle. Therefore, our aim was to develop an optimized custom made prosthesis for total talus replacement providing a high level of primary stability. A custom made hemiprosthesis was developed using computed tomography and magnetic resonance imaging data of the affected and contralateral talus considering the principles and technology for the development of the S.T.A.R. prosthesis (Stryker). Additionally, four eyelets for fixation of artificial ligaments were added at the correspondent footprints of the most important ligaments. Two modifications can be provided according to the clinical requirements: A tri-articular hemiprosthesis or a bi-articular hemiprosthesis combined with the tibial component of the S.T.A.R. total ankle replacement system. A feasibility study was performed using a fresh frozen human cadaver. Maximum range of motion of the ankle was measured and ligamentous stability was evaluated by use of standard X-rays after application of varus, valgus or sagittal stress with 150 N. Correct implantation of the prosthesis was technically possible via an anterior approach to the ankle and using standard instruments. Malleolar osteotomies were not required. Maximum ankle dorsiflexion and plantarflexion were measured as 22-0-28 degrees. Maximum anterior displacement of the talus was 6 mm, maximum varus tilt 3 degrees and maximum valgus tilt 2 degrees. Application of an internally braced prosthesis for total talus replacement in humans is technically feasible and might be a reasonable procedure in carefully selected cases with no better alternatives left.

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The Talar Body Prosthesis: Results at Ten to Thirty-six Years of Follow-up

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 71 publications

References 6 publications

An Alumina Ceramic Total Talar Prosthesis for Osteonecrosis of the Talus

An Alumina Ceramic Total Talar Prosthesis for Osteonecrosis of the Talus

Custom-Made Alumina Ceramic Total Talar Prosthesis for Idiopathic Aseptic Necrosis of the Talus: Report of Two Cases

Development of an internally braced prosthesis for total talus replacement

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