The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus

Taniguchi, Akira; Takakura, Yoshinori; Sugimoto, Kazuya; Hayashi, Kôji; Ouchi, Kazuo; Kumai, Tsukasa; Tanaka, Yasuhito

doi:10.1302/0301-620x.94b11.29543

Cited by 77 publications

(77 citation statements)

References 19 publications

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“…Both were found to have an acceptable clinical outcome but also caused a few problems. Taniguchi et al voiced concern about loosening and sinking between the talar body prosthesis and the talar neck [6] and recommended using a third-generation prosthesis that completely replaces the talus [7]. As in our two cases, Ando et al found that total replacement with a third-generation talar prosthesis for necrosis of the talus achieved a much better outcome in a 72-year-old woman at 2 years after surgery [23].…”

Section: Discussionmentioning

confidence: 83%

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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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Section: Discussionmentioning

confidence: 83%

“…The alumina ceramic talar body prosthesis was designed in Japan to replace defects in the talar body and preserve movement of the ankle [5, 6]. The first-generation implant, which had a peg on the anterior surface of the implant, was inserted into the head of the talus and fixed with bone cement.…”

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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“…Total talar replacement with a prosthesis was first performed in Japan in 1999. Several subsequent prosthetic design revisions have resulted in improved outcomes after prosthesis implantation[14]. Taniguchi et al[14] reported favorable results in eight of 14 patients after a mean follow-up period of 83 mo using a second-generation prosthesis which only partially replaced the talar body.…”

Section: Introductionmentioning

confidence: 99%

“…Several subsequent prosthetic design revisions have resulted in improved outcomes after prosthesis implantation[14]. Taniguchi et al[14] reported favorable results in eight of 14 patients after a mean follow-up period of 83 mo using a second-generation prosthesis which only partially replaced the talar body. As mentioned in their report, the third-generation prosthesis completely replacing the talus is currently recommended and has been associated with much better outcomes than the second-generation prosthesis[14].…”

Section: Introductionmentioning

confidence: 99%

“…Taniguchi et al[14] reported favorable results in eight of 14 patients after a mean follow-up period of 83 mo using a second-generation prosthesis which only partially replaced the talar body. As mentioned in their report, the third-generation prosthesis completely replacing the talus is currently recommended and has been associated with much better outcomes than the second-generation prosthesis[14]. Tsukamoto et al[10] first reported treatment of talar collapse after total ankle arthroplasty in a patient with rheumatoid arthritis by talar replacement with a third-generation prosthesis.…”

Section: Introductionmentioning

confidence: 99%

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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 stability of total talar prosthesis—How stable to dislocation? Cadaveric study

Sato

Saengsin

Sornsakrin

et al. 2021

Journal Orthopaedic Research

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The aim of this study was to characterize ankle stability of total talar prosthesis (TTP) and to determine the effect of implant sizes on stability as well as the resistance to TTP dislocation. Twelve below‐knee cadaveric specimens were divided into two groups. Group 1 received a size matched implant and Group 2 received downsized implant by 5%. The stability assessment under fluoroscopy was performed for each cadaver in its native state. Following TTP insertion process, each then underwent evaluation of the TTP ankle stability. The stability of pre‐ and post‐TTP was compared. (1) Anterior drawer distance. (2) Talar tilt angle under varus and valgus stress. (3) Subtalar tilt angle under varus stress was measured. Finally, the dislocation test was performed using the aforementioned testing conditions, then the stress force was slowly increased from 0 to 350 N, during which time it was observed on fluoroscopy all the time. Compared to pre TTP ankles, varus and anterior drawer stress showed significant instability (p < 0.001–0.031). Only anterior drawer stress in smaller sized implants showed significant instability when compared to identical sized implants (p = 0.008). No dislocation was seen under varus, valgus, and subtalar stress. However, anterior dislocation was observed in all cases of smaller size implant group (p = 0.045). TTP implant was stable under valgus and subtalar stress. However, clinicians should pay attention to anterior instability. Notably, downsized implants should be considered carefully to minimize the chance of anterior dislocation.

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The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus

Cited by 77 publications

References 19 publications

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

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

The stability of total talar prosthesis—How stable to dislocation? Cadaveric study

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