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Reconstruction after Talar Tumor Resection: A Systematic Review
Shinji Tsukamoto1, Andreas F Mavrogenis2, Kanya Honoki1
1Department of Orthopaedic Surgery, Nara Medical University, Nara 634-8521, Japan.
Current Oncology (Toronto, Ont.)
|December 22, 2022
Summary
Talar tumor resection reconstruction using talar prosthesis shows better functional outcomes and fewer complications than tibiocalcaneal fusion. Further randomized trials are needed to confirm these findings in talar reconstruction.
Area of Science:
- Orthopedic oncology
- Surgical reconstruction
- Biomechanical outcomes
Background:
- Talar tumors necessitate complex surgical resection and reconstruction.
- Evaluating functional outcomes and complications of different reconstruction methods is crucial for patient management.
Approach:
- Systematic review of PubMed, Embase, and Cochrane Central Register of Controlled Trials.
- Included 20 studies (23 patients) comparing tibiocalcaneal fusion, frozen autograft, and talar prosthesis reconstruction.
- Analyzed Musculoskeletal Tumor Society scores and complication rates.
Key Points:
- Talar prosthesis group (n=5) demonstrated superior mean Musculoskeletal Tumor Society scores (90) compared to tibiocalcaneal fusion (n=17, 77.6) and frozen autograft (n=1, 70).
- Tibiocalcaneal fusion group reported sensory deficits (6%) and venous thrombosis (12%).
- Frozen autograft group experienced osteoarthritis (100%), while the talar prosthesis group had no reported complications.
Conclusions:
- Talar prosthesis reconstruction appears preferable to tibiocalcaneal fusion after talar tumor resection due to improved function and safety.
- Current evidence is limited by retrospective study designs and small patient numbers.
- Future randomized controlled trials with larger cohorts are warranted to validate these results.
