Total talar replacement with a novel 3D printed modular prosthesis for tumors

Fang, Xiang; Liu, Hongyuan; Xiong, Yan; Zhang, Wenli; Luo, Yi; Wu, Fan; Zhou, Yong; Song, Liuhong; Yu, Zeping; Tu, Chongqi; Duan, Hong

doi:10.2147/tcrm.s172442

Cited by 31 publications

(31 citation statements)

References 28 publications

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“…However, there is always controversy about whether the whole talar prosthesis should be xed after implantation. Regardless of whether the subtalar joint or subtalar joint is fused, the degree of exibility and range of motion of the foot are affected [13]. If we choose not to x the talar prosthesis [11,12] and use the bony structure of the talus between the ankle points and the ankle-foot complex to obtain self-stability, damage to the adjacent articular cartilage and complications such as prosthesis dislocation may occur.…”

Section: Discussionmentioning

confidence: 99%

“…It is traditionally believed that xation must be performed after the prosthesis is inserted, which is similar to fusion surgery. The subtalar joint [13] needs to be xed or the scaphoid joint needs to be xed at the same time to stabilize the prosthesis at the ankle. For the prosthesis-bone interface needing screw xation, a special coating is often used to achieve the biomechanical effect of bone ingrowth.…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies by Kadakia et al [11] and Tracy et al [12], the peritalar soft tissue was directly removed without xation of the talar prosthesis with screws. In studies conducted in China, screws have been used to x only the subtalar joint [13] or both the subtalar joint and the subtalar joint at the same time.…”

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: Establishment of a Finite Element Model and Biomechanical Analysis of Different Fixation Methods for Total Talar Prosthesis Replacement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

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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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“…Sixth, this case-control study only proved that the 3DMMI-based virtual surgical planning and 3DMMI-based PSI may be superior to the traditional surgical plan and technique without CAS. However, the encouraging preliminary results endorse more studies on virtual surgical planning with 3DMMI, based on which precise resection and reconstruction with CAS might be achieved, within, or even beyond the pelvis 37,38…”

Section: Discussionmentioning

confidence: 75%

Improved virtual surgical planning with 3D-multimodality image for malignant giant pelvic tumors

Fang

Xiong

et al. 2018

CMAR

Self Cite

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We sought to assess the early clinical outcome of 3D-multimodality image (3DMMI)based virtual surgical planning for resection and reconstruction of malignant giant pelvic tumors. Patients and methods: In this retrospective case-control study, surgery was planned and performed with 3DMMI-based patient-specific instruments (PSI) in 13 patients with giant pelvic malignancy and without 3DMMI-based PSI in the other 13 patients. In the 3DMMI group, 3DMMI was utilized, taking advantages of computed tomography (CT), contrast-enhanced CT angiography (CTA), contrast-enhanced magnetic resonance imaging (MRI), contrast-enhanced magnetic resonance neurography (MRN), which could reveal the whole tumor and all adjacent vital structures. Based on these 3DMMI, virtual surgical planning was conducted and the corresponding PSI was then designed. The median follow-up was 8 (3-24) months. The median age at operation was 37.5 (17-64) years. The mean tumor size in maximum diameter was 13.3 cm. Surgical margins, intraoperative and postoperative complications, duration of surgery, and intra-operative blood loss were analyzed. Results: In the non-3DMMI group, the margins were wide in six patients (6/13), marginal in four (4/13), wide-contaminated in two (2/13), and intralesional in one (1/13). In the 3DMMI group, the margins were wide in 10 patients (10/13), marginal in three (3/13), and there were no wide-contaminated or intralesional margins. The 3DMMI group achieved shorter duration of surgery (P=0.354) and lower intraoperative blood loss (P=0.044) than the non-3DMMI group. Conclusion: The 3DMMI-based technique is advantageous to obtain negative surgical margin and decrease surgical complications related to critical structures injury for malignant giant pelvic tumor.

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“…3D‐printing technology has presented new concepts in clinical practice, especially in orthopedics and plastic surgery . It enables reconstruction based on the patient's own anatomical geometrics, and thus limb salvage surgery, TUR, could be safely performed.…”

mentioning

confidence: 99%

Total ulna replacement with a 3D‐printed custom‐made prosthesis after en bloc tumor resection: A case report

Fang

Zhang

et al. 2018

Pediatric Blood & Cancer

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Total talar replacement with a novel 3D printed modular prosthesis for tumors

Cited by 31 publications

References 28 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

Improved virtual surgical planning with 3D-multimodality image for malignant giant pelvic tumors

Total ulna replacement with a 3D‐printed custom‐made prosthesis after en bloc tumor resection: A case report

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