Total talar prosthesis with and without ankle ligament reconstruction using the three-dimensional computer-aided design and computer numerical control manufacturing techniques

Angthong, Chayanin; Rajbhandari, Prasit

doi:10.4081/or.2020.8844

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…Kadakia et al 9 reported 1 patient with distal tibial AVN and Abramson et al 1 reported 1 of 8 patients with minor tibial wear. Angthong and Rajbhandari 2 did not find any radiologic signs of loosening. Morita et al reported tibiotalar osteophyte changes in 47% preoperatively and in 90% postoperatively.…”

Section: Ttrmentioning

confidence: 84%

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Total Talus Replacements

Jennison

Dalgleish

Sharpe

et al. 2023

Foot & Ankle Orthopaedics

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Background: Total talus replacements are a surgical treatment for talar avascular necrosis (AVN) replacing the entire talus. The potential for total talus replacements has increased with the advent of patient-specific implants using 3D printing based on computed tomographic scanning of the ipsilateral or contralateral talus. The primary aim of this review is to summarize the literature on total talus replacements, providing a historical survey, indications, controversies, complications, survival, and functional outcomes. Methods: A systematic review was performed. Articles with survival of total talus replacements were included. Basic percentages and a critical review of the literature was performed. Results: Nine articles with 115 patients were included. The mean age ranged from 27.6 to 72 years, but with 5 studies having a mean age of <50 years. Mean follow-up ranged from 12.8 to 152 months. The most common indication was avascular necrosis in 67 patients (58%). Five studies used customized implants and 4 studies used 3D printing. Four studies used ceramic prostheses, 3 cobalt chromium, 1 stainless steel, and 1 titanium with ceramic surface. Three studies involved a talus replacement in conjunction with an ankle replacement. Postoperative complications ranged from 0% to 33%. Of 24 functional outcomes scores, 66.7% demonstrated significant improvement. Conclusion: Total talus replacements are a promising alternative to tibiotalocalcaneal fusion for patients with avascular necrosis of the talus; however, further studies are required to ensure reliable outcomes prior to widespread adoption of this technology. Level of Evidence: Level IV, review of case series.

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Section: Ttrmentioning

confidence: 84%

“…Three studies analyzed gait. One patient of 5 in the study by Angthong and Rajbhandari 2 had stiffness in the subtalar joint and 1 had limited weightbearing due to pain. Abramson et al 1 found 7 of 8 patients had decreased subtalar ROM and minor gait abnormalities, with 3 also suffering fixed hindfoot varus and 3 discomfort on ankle movement.…”

Section: Ttrmentioning

confidence: 98%

Total Talus Replacements

Jennison

Dalgleish

Sharpe

et al. 2023

Foot & Ankle Orthopaedics

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“…With the development of digital orthopedics and additive manufacturing technologies, three-dimensional printed (3D printed) talus body prosthesis or total talus prosthesis has been gradually applied in talus reconstruction [ 17 – 19 ]. In patients managed with 3D printed talus prosthesis following talus necrosis, it was reported a certain extent of joint mobility recovery; significant improvement of the limb function with early weight-bearing activities allowed and negligible leg length dis crepancy [ 20 – 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, due to the rarity of talus malignant tumors, there are very few reports on the reconstruction of the talus [ 7 ]. Additionally, most literatures are confined to the case reports, resulting in the unclear clinical efficacy of 3D printed talus prosthesis approach in management of talus malignant tumor patients [ 17 – 19 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional printed custom-made modular talus prosthesis in patients with talus malignant tumor resection

He,

Lu,

Zou

et al. 2024

J Orthop Surg Res

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Background Talar malignant tumor is extremely rare. Currently, there are several alternative management options for talus malignant tumor including below-knee amputation, tibio-calcaneal arthrodesis, and homogenous bone transplant while their shortcomings limited the clinical application. Three-dimensional (3D) printed total talus prosthesis in talus lesion was reported as a useful method to reconstruct talus, however, most researches are case reports and its clinical effect remains unclear. Therefore, the current study was to explore the application of 3D printed custom-made modular prosthesis in talus malignant tumor. Methods We retrospectively analyzed the patients who received the 3D printed custom-made modular prosthesis treatment due to talus malignant tumor in our hospital from February 2016 to December 2021. The patient's clinical data such as oncology outcome, operation time, and volume of blood loss were recorded. The limb function was evaluated with the Musculoskeletal Tumor Society 93 (MSTS-93) score, The American Orthopedic Foot and Ankle Society (AOFAS) score; the ankle joint ranges of motion as well as the leg length discrepancy were evaluated. Plain radiography and Tomosynthesis-Shimadzu Metal Artefact Reduction Technology (T-SMART) were used to evaluate the position of prosthesis and the osseointegration. Postoperative complications were recorded. Results The average patients’ age and the follow-up period were respectively 31.5 ± 13.1 years; and 54.8 months (range 26–72). The medium operation time was 2.4 ± 0.5 h; the intraoperative blood loss was 131.7 ± 121.4 ml. The mean MSTS-93 and AOFAS score was 26.8 and 88.5 respectively. The average plantar flexion, dorsiflexion, varus, and valgus were 32.5, 9.2, 10.8, and 5.8 degree respectively. One patient had delayed postoperative wound healing. There was no leg length discrepancy observed in any patient and good osseointegration was observed on the interface between the bone and talus prosthesis in all subjects. Conclusion The modular structure of the prosthesis developed in this study seems to be convenient for prosthesis implantation and screws distribution. And the combination of solid and porous structure improves the initial stability and promotes bone integration. Therefore, 3D printed custom-made modular talus prosthesis could be an alternative option for talus reconstruction in talus malignant tumor patients.

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“…Most commonly, this involves a modified Brostrom procedure to address chronic lateral ankle instability at the time of the TAR procedure. As a corollary, it should also be critical to achieve ligamentous stability for TTR and TATTR constructs to optimize outcomes [12][13][14][15][16] .…”

mentioning

confidence: 99%

A Novel Technique for Lateral Ankle Ligament Reconstruction with Total Ankle Total Talus Replacement

Tabarestani

Anastasio

Lukosius

et al. 2023

JBJS Case Connector

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Case:A 65-year-old man with severe left talar avascular necrosis, arthritis, and chronic lateral ankle instability underwent total ankle total talus replacement (TATTR) with lateral ligament reconstruction. Tibial component placement was performed using preoperative computed tomography navigation and patient-specific guides. A custom, total talus replacement to mate with the fixed-bearing tibial component was implanted. Last, a modified Brostrom procedure was performed to restore lateral ankle stability. The patient has performed well through 1 year with improved pain-free function.Conclusion:This case report details a novel technique for performing a modified Brostrom procedure in conjunction with TATTR to restore lateral ankle stability.

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Total talar prosthesis with and without ankle ligament reconstruction using the three-dimensional computer-aided design and computer numerical control manufacturing techniques

Cited by 5 publications

References 14 publications

Total Talus Replacements

Total Talus Replacements

Three-dimensional printed custom-made modular talus prosthesis in patients with talus malignant tumor resection

A Novel Technique for Lateral Ankle Ligament Reconstruction with Total Ankle Total Talus Replacement

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