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Total talar prosthesis with and without ankle ligament reconstruction using the three-dimensional computer-aided
Chayanin Angthong1, Prasit Rajbhandari2
1Orthopaedic Service, Faculty of Medicine, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand.
Orthopedic Reviews
|December 14, 2020
Summary
Customized total talar prostheses, manufactured using 3D CAD and CNC, show promising short-term results for severe talus damage. This innovative approach improves patient outcomes in complex ankle reconstruction cases.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Medical device manufacturing
Background:
- Severe talus damage and bone loss present significant challenges due to the talus's complex anatomy and function.
- Existing treatments for extensive talar defects may be limited, necessitating advanced reconstructive options.
Purpose of the Study:
- To outline the manufacturing process for custom total talar prostheses using 3D Computer-Aided Design (CAD) and Computer Numerical Control (CNC).
- To evaluate the clinical outcomes of total talar prosthesis replacement, with or without ankle ligament reconstruction, in patients with severe talar conditions.
Main Methods:
- A case series involving five patients with severe talar loss or damage (mean age: 27.6 years).
- Manufacturing of patient-specific total talar prostheses utilizing 3D CAD and CNC technology.
- Surgical implantation of prostheses, with subsequent clinical evaluation at a mean follow-up of 17.8 months.
Main Results:
- The study reported a 20% incidence of mild subsidence and a 20% incidence of periprosthetic fracture.
- Significant improvements were observed in mean clinical scores, including the Visual Analog Scale-Foot and Ankle (VAS-FA) and the Short Form 36 (SF-36).
Conclusions:
- Customized total talar prostheses offer a viable solution for treating severe talus damage and bone loss.
- Satisfactory short-term outcomes suggest the potential of this technique in complex orthopedic cases.
