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Development of an internally braced prosthesis for total talus replacement.
Markus Regauer1, Mirjam Lange1, Kevin Soldan1
1Markus Regauer, Mirjam Lange, Sebastian Baumbach, Wolfgang Böcker, Hans Polzer, Klinik für Allgemeine, Unfall und Wiederherstellungschirurgie, Klinikum der Ludwig-Maximilians-Universität München, 81377 Munich, Germany.
World Journal of Orthopedics
|April 1, 2017
Summary
Total talus loss presents a surgical challenge. A novel, custom-designed prosthesis with integrated ligament fixation offers a feasible solution for talus replacement, enhancing ankle stability.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Total talus loss from trauma or avascular necrosis poses significant challenges in foot and ankle surgery.
- Current treatment options for talus loss are limited, necessitating innovative solutions.
Purpose of the Study:
- To develop an optimized custom-made prosthesis for total talus replacement.
- To enhance primary stability and ligamentous integrity in total talus prostheses.
Main Methods:
- A custom hemiprosthesis was designed using CT and MRI data, incorporating principles from the S.T.A.R. prosthesis.
- Eyelets for artificial ligament fixation were integrated into the prosthesis design.
- A feasibility study was conducted on a fresh frozen human cadaver, assessing range of motion and ligamentous stability under stress.
Main Results:
- The custom prosthesis was implantable via an anterior approach without requiring malleolar osteotomies.
- The study measured maximum ankle dorsiflexion/plantarflexion (22-0-28 degrees) and assessed talar displacement and tilt under stress.
- Ligamentous stability evaluations indicated feasibility for the internally braced prosthesis.
Conclusions:
- Custom-made, internally braced prostheses for total talus replacement are technically feasible.
- This approach may offer a viable treatment option for carefully selected patients with no alternative solutions.