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Outcomes and classification of total talus replacements.
Mark B Davies1, Ciaran Nolan1, Ian T Sharpe2
1Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
The Bone & Joint Journal
|February 28, 2026
Summary
Total talus replacement (TTR) offers significant pain relief and functional improvement for patients with talus destruction. This study shows TTR effectively enhances patient outcomes and activity levels, with good results for both articulating and constrained implants.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Reconstructive surgery
Background:
- Total talus replacement (TTR) is an emerging surgical technique.
- Increasing availability necessitates understanding its clinical outcomes.
- Data on TTR in the UK population is limited.
Purpose of the Study:
- To present the largest UK series of TTRs.
- To describe outcomes, functional expectations, and complications.
- To evaluate patient-reported outcome measures (PROMs) post-TTR.
Main Methods:
- Study included 27 consecutive TTRs from June 2019 to December 2024.
- PROMs (MOXFQ, VAS, EQ-5D, TAS) were collected prospectively.
- Compared outcomes for articulating vs. constrained implants and elective vs. trauma cases.
Main Results:
- Significant improvements in MOXFQ (80.8% to 43.2%), VAS (44.5 to 76.2), and EQ-5D (10.7 to 7.4) were observed (p < 0.001).
- Tegner Activity Scale increased by 1.8 points.
- 11% revision rate (n=3), two for increased constraint, one for deep infection.
Conclusions:
- TTR effectively relieves pain and improves function and activity in patients with talus destruction.
- Elective TTR cases showed better improvement than post-traumatic cases.
- Constrained and articulating implants yielded similar results; standardized terminology is crucial for future studies.
