Custom Patient-Specific 3D-Printed Titanium Truss Tibiotalocalcaneal Arthrodesis Implants for Failed Total Ankle...

Area of Science:

• Orthopedic surgery
• Biomaterials engineering
• Medical device technology

Background:

• Managing failed total ankle replacements with significant bone loss presents challenges due to high complication rates.
• Patient-customized 3D-printed titanium truss arthrodesis implants represent a novel salvage option.

Purpose of the Study:

• To evaluate the efficacy of custom 3D-printed titanium truss arthrodesis implants in managing failed total ankle replacements.
• To develop technical tips, a classification system, and a treatment algorithm based on initial clinical experience.

Main Methods:

• A prospective observational study involving 6 patients with failed total ankle replacements.
• Management with custom patient-specific 3D-printed titanium truss arthrodesis implants.
• Development of technical guidelines and a treatment algorithm.

Main Results:

• Significant improvement in MOXFQ Index (73.1 to 32.3) and EQ-5D-5L Index (0.366 to 0.743) post-surgery.
• Mean follow-up of 3.0 years with no cases of nonunion.
• Overall complication rate of 50%, with two patients requiring reoperation for reasons other than nonunion or revision fixation.

Conclusions:

• Custom patient-specific 3D-printed titanium truss arthrodesis implants are a viable treatment option for failed total ankle replacements.
• This technology provides a promising alternative for salvage in complex cases with bone stock loss.