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The talar body prosthesis
T Harnroongroj1, V Vanadurongwan
1Department of Orthopaedic Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
The Journal of Bone and Joint Surgery. American Volume
|October 6, 1997
Summary
A novel talar body prosthesis preserves ankle and foot function after avascular necrosis or crush fractures. This talar replacement shows promising long-term results, maintaining mobility and reducing disability.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Podiatric medicine
Background:
- Arthrodesis or talectomy for talar avascular necrosis or crush fractures often leads to ankle and foot disability.
- Existing treatments can compromise the function of the ankle and foot.
Purpose of the Study:
- To evaluate the efficacy of a newly developed talar body prosthesis.
- To preserve ankle and foot function in patients with avascular necrosis or severe crush fractures of the talus.
Main Methods:
- A talar body prosthesis was designed to replace the talus while preserving its neck and head for stem insertion.
- A transmedial malleolar approach was used for prosthesis insertion.
- Sixteen patients (12 with avascular necrosis, 4 with crush fractures) received the prosthesis between 1974 and 1990.
Main Results:
- Three patients evaluated at 5 years had satisfactory results.
- One prosthesis failed at 8 months due to undersized posterior facet causing calcaneal erosion.
- Satisfactory results were observed in 3 patients at 6-10 years and 8/9 patients at 11-15 years.
- One late failure occurred due to prosthetic stem sinking into the talar neck, requiring revision.
Conclusions:
- The talar body prosthesis is a viable option for replacing the talus in cases of avascular necrosis or severe crush fracture.
- This prosthesis can maintain ankle and foot function for extended periods.
- Careful consideration of prosthesis sizing and stem fixation is crucial for long-term success.