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A Novel Indication for 3D-Printed Titanium Total Talus Replacements in Isolated Talar Tumors
Martina Galea Wismayer1, Harriet Branford-White2, Mark B Davies3
1Foot & Ankle Fellow, Nuffield Orthopaedic Centre, Oxford, UK.
Foot & Ankle Orthopaedics
|February 14, 2025
Summary
Total talus replacement (TTR) offers a promising alternative for rare intraosseous talar tumors. This novel approach improved patient function and reduced pain, avoiding complex fusions.
Area of Science:
- Orthopedic surgery
- Oncology
- Biomedical engineering
Background:
- Intraosseous talar tumors are rare, often necessitating complex surgeries like tibiocalcaneal fusion, which can lead to poor functional outcomes.
- Total talus replacement (TTR) is typically used for avascular necrosis post-trauma, but its application for talar tumors is novel.
- This study explores TTR as a treatment for isolated talar tumors without osteoarthritis.
Observation:
- Four patients with isolated intraosseous talar tumors (fibrous dysplasia, vascular tumor, metastatic endometrial carcinoma) underwent TTR using 3D-printed implants.
- Procedures were performed between February 2021 and December 2022 by a single surgical team.
- Patient-reported outcomes were assessed using the Manchester-Oxford Foot Questionnaire (MOXFQ) and EuroQoL-5 Dimensions (EQ-5D) pre- and postoperatively.
Findings:
- At a mean 26-month follow-up, all patients demonstrated improved MOXFQ and EQ-5D scores, with average MOXFQ decreasing from 57.3 to 20.3.
- Three patients reported enhanced function and ability to perform daily activities, while one noted improved mobility.
- No intraoperative or postoperative complications were observed in any patient.
Implications:
- Total talus replacement (TTR) presents a viable surgical alternative for managing isolated talar tumors.
- This technique preserves joint movement, potentially offering superior functional results compared to traditional fusion methods.
- Further research with larger cohorts is warranted to validate TTR's long-term efficacy and benefits in talar tumor treatment.
