Total Talar Replacements Short-Medium Term Case Series, South Africa 2019

Abramson, Michael; Hilton, Thomas L.; Hosking, Keith; Campbell, Neil; Dey, Roopam; McCollum, Graham

doi:10.1053/j.jfas.2020.08.015

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…One major concern surrounding the use of TTPs has been the more easily inserted but undersized implant, which may result in subtalar instability. Abramson et al 14 showed that the hindfoot varus is seen in three postoperative patients across a case series of eight patients treated with undersized TTP implant. They proposed that overstuffing can be prevented through undersizing of implants by 2.5%, but that this would also alter the kinematics and mobility of the subtalar joint.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…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. Katsui et al 11 found 2 of the 6 patients had limited ROM.…”

Section: Ttrmentioning

confidence: 99%

“…Studies reported varied radiologic outcomes. 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.…”

Section: Ttrmentioning

confidence: 99%

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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“…This reduced the pre-surgical planning and hands-on practice in fixing the screws with precision on the implant. Electron beam melting was used to fabricate implants to replace a defective Talus bone [124]. The implant was further coated with wear-resistant titanium oxide surface layer and currently at human trial stages.…”

Section: Am Applications In Medical and Biomedical Application 421 Me...mentioning

confidence: 99%

Global perspective and African outlook on additive manufacturing research − an overview

et al. 2022

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Additive manufacturing (AM) technologies and advances made globally in medicine, construction, aerospace, and energy sectors are discussed. The paper further explores the current state of AM innovation and development landscape in Africa as a late comer to this area of smart manufacturing. Peer-reviewed and published literature were retrieved from Scopus database from 2005 to 2021 and analysed. In Africa, out of 500 published articles, South Africa has the highest research throughput, whereas about two-thirds of the continent is not actively participating in this burgeoning field. The main AM techniques most widely used are selective laser melting, fused deposition modelling, and direct energy deposition. Globally, there is an interplay of computational (machine learning and mechanistic models) and experimental approaches to understanding the physical metallurgy of AM techniques and processes. Though this trend is consistent with global practices, Africa lags the world in AM technologies, a niche that could leapfrog the manufacturing sector. Thus, Africa need to foster collaborative partnership within and globally to become an active global player in this industry.

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Total Talar Replacements Short-Medium Term Case Series, South Africa 2019

Cited by 7 publications

References 22 publications

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

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

Total Talus Replacements

Global perspective and African outlook on additive manufacturing research − an overview

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