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Custom-Made Total Talonavicular Replacement in a Professional Rock Climber
Sandro Giannini1, Matteo Cadossi2, Antonio Mazzotti3
1Professor, I Clinic of Orthopaedic and Traumatology, Istituto Ortopedico Rizzoli, Bologna University, Bologna, Italy.
Summary
A custom talonavicular prosthesis successfully restored high-level function in a professional athlete after complex ankle injury. This innovative solution enabled a full return to sport, demonstrating its effectiveness for demanding patients.
Area of Science:
- Orthopaedic surgery
- Biomedical engineering
- Sports medicine
Background:
- Restoring joint function after complex articular fractures is challenging for athletes.
- Post-traumatic arthritis can significantly impair ankle mobility and athletic performance.
Observation:
- A professional rock climber with post-traumatic ankle and talonavicular arthritis underwent implantation of the first custom-made talonavicular prosthesis.
- The prosthesis was designed using CT scans of the contralateral ankle and fabricated with direct metal laser sintering.
Findings:
- The patient achieved excellent functional scores (Tegner 9/10) and resumed full sporting activity 30 months post-surgery.
- American Orthopaedic Foot and Ankle Society scores improved from 36 to 81, with no signs of radiolucency.
- 3D videofluoroscopy confirmed 15° dorsiflexion and 4° plantar flexion at the ankle.
Implications:
- Customized prostheses offer a viable alternative to standard treatments like arthrodesis for high-functionality patients.
- This approach can effectively address complex ankle injury sequelae and meet patient expectations for returning to demanding activities.
- The study highlights the potential of patient-specific implants in advanced orthopaedic reconstruction.
