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

There are few surgical options available to manage complex talar pathology that result in predictably acceptable functional and patient satisfaction scores. Recently, total talar replacement has gained popularity as a viable option. This study presents the clinical outcomes of a case series of total talar replacements in South Africa. A review of data for 8 (N = 8) consecutive patients who underwent total talus replacement between July 2014 and August 2018 was performed. The American Orthopedic Foot and Ankle Society hindfoot score was used to assess clinical function and the Short Form-36 was used to assess patient satisfaction. Patient demographics as well as data on pathology, range of motion, gait analysis, and radiological outcomes were included. The mean age was 46 (range, 23-71) years. Pathologies included trauma, avascular necrosis, and tumors. The mean duration of follow-up was 23 (range, 12-49) months. The mean American Orthopedic Foot and Ankle Society score was 79.25 (range, 69-88) and the mean Short Form-36 satisfaction score was 83.25 (range, 60-93). No revision surgeries have been performed to date. Seven patients demonstrated a mildly abnormal gait and 1 revealed a moderately abnormal gait. The patient with the longest duration of follow-up showed radiological changes of tibial wear, although he remained symptom free. Our experience with the patients described in this report leads us to believe that total talar replacement is a viable surgical option in appropriately selected patients with end-stage talar pathology in the short to medium term, without compromising future salvage options.