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Related Experiment Video

Updated: Aug 30, 2025

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Improved Pain and Function After TTC Fusion With a Custom Cage.

Steven M Raikin1, Tara Gaston Moncman1, Jared Raikin2

  • 1Rothman Orthopaedic Institute, Philadelphia, PA, USA.

Foot & Ankle International
|September 1, 2022
PubMed
Summary

Three-dimensional custom cages show promise for complex ankle fusions with significant bone loss, achieving good fusion rates but modest functional improvements. This technology offers a viable option for limb-salvaging procedures.

Keywords:
3D-printed cagecustom cagepatient-specific implantstibiotalarcalcaneal fusion

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Complex ankle and hindfoot pathology often involves significant bone loss, necessitating advanced reconstructive techniques.
  • Tibiotalocalcaneal (TTC) fusion is a common procedure, but outcomes can be limited by bone defects.
  • Three-dimensional (3D) custom cages offer a potential solution for managing large bone defects in TTC fusions.

Purpose of the Study:

  • To evaluate the clinical and radiologic outcomes of patient-specific 3D-printed custom cages used in limb-salvaging TTC fusions.
  • To assess the efficacy of custom cages in addressing massive bone loss around the ankle joint.
  • To compare outcomes with existing literature on TTC fusions.

Main Methods:

  • Retrospective review of 21 patients undergoing custom cage implantation with a TTC retrograde fusion nail.
  • Data collected included pain scores (VAS), functional outcomes (FAAM), and general health surveys (SF-12).
  • Mean follow-up was 32 months, with analysis of preoperative and postoperative data.

Main Results:

  • 95.2% of cages remained in situ at final follow-up.
  • Significant improvements were observed in pain, daily living activities, and mental/physical health scores.
  • Despite improvements, patients remained relatively disabled compared to the general population; 2 failures occurred.

Conclusions:

  • 3D-printed custom cages are a viable option for complex TTC fusions with significant bone loss.
  • The technology demonstrates good fusion rates, though functional outcome improvements are modest.
  • Further research with larger cohorts is warranted to fully elucidate long-term benefits.