3D printing technology: Rethinking the approach to talar surgery; a literature review

Authors

  • Ebony Love, DPM, DABPM, AASPS, FAPWH Associate Professor, Department of Medicine, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
  • Laura E. Sansosti, DPM, FACFAS Assistant Professor, Department of Biomechanics and Surgery, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania USA
  • Ziad G. Labbad, MD, DPM, CPed Clinical Professor, Department of Medicine, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
  • Khurram Khan, DPM, FACFAS, FACPM Associate Professor, Department of Medicine, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
  • Alyssa Kellmyer, BS Student, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
  • Priyanka Reddy, BBA Student, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
  • Sarah Ayvazov, BS Student, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
  • Michael Siciliano, BA Student, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
  • Jessica Somma, BS Student, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
  • Griffin Van, BS Student, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA

Keywords:

ankle, arthritis, bone, implant, replacement, tarsal

Abstract

Talar fractures account for less than 1% of all fractures, yet despite this low occurrence they represent a major reconstruction challenge for surgeons. While total talar replacements are seldom used, there are very few procedures that can simultaneously repair a damaged talus and allow the patient to retain adequate range of motion, joint stability, function and satisfaction. These factors have become the impetus for exploring the role of 3D printing as a relatively novel surgical intervention for reconstructing the talus. Specific indications for a 3D printed total talar replacement include severe osteoarthritis, avascular necrosis, osteomyelitis, and trauma especially in the setting of a juvenile patient. As a relatively new approach, there is still much to be explored in regards to creating a 3D printed talar prosthesis, and the utility of the technology would greatly benefit from further research and development. Based upon our initial review of seven different studies, the use of 3D printed talar implants, when surgically indicated, demonstrates promising results in increasing patient satisfaction and improving postsurgical outcomes when compared to more conventional methods of repair. Thus, 3D printed talar implants represent a potentially viable tool to be considered by surgeons for a more precise and patient outcome-driven solution following talar injury.

References

Ramsey PL, Hamilton W. Changes in tibiotalar area of contact caused by lateral talar shift. J Bone Joint Surg Am. 1976 Apr;58(3):356-7. PMID: 1262367.

Higgins TF, Baumgaertner MR. Diagnosis and treatment of fractures of the talus: a comprehensive review of the literature. Foot Ankle Int. 1999 Sep;20(9):595-605. doi: 10.1177/107110079902000911. PMID: 10509689.

Ohl X, Harisboure A, Hemery X, Dehoux E. Long-term follow-up after surgical treatment of talar fractures: Twenty cases with an average follow-up of 7.5 years. Int Orthop. 2011 Jan;35(1):93-9. doi: 10.1007/s00264-009-0930-y. Epub 2009 Dec 22. PMID: 20033158; PMCID: PMC3014484.

Chiu SY, Wan KW. Use of Three-Dimensional Printing Techniques in the Management of a Patient Suffering From Traumatic Loss of the Talus. J Foot Ankle Surg. 2019 Jan;58(1):176-183. doi: 10.1053/j.jfas.2018.08.008. PMID: 30583778.

Fang X, Liu H, Xiong Y, Zhang W, Luo Y, Wu F, Zhou Y, Song L, Yu Z, Tu C, Duan H. Total talar replacement with a novel 3D printed modular prosthesis for tumors. Ther Clin Risk Manag. 2018 Oct 5;14:1897-1905. doi: 10.2147/TCRM.S172442. PMID: 30323612; PMCID: PMC6178937.

Tracey J, Arora D, Gross CE, Parekh SG. Custom 3D-Printed Total Talar Prostheses Restore Normal Joint Anatomy Throughout the Hindfoot. Foot Ankle Spec. 2019 Feb;12(1):39-48. doi: 10.1177/1938640018762567. Epub 2018 Mar 14. PMID: 29537314.

Hamid KS, Parekh SG, Adams SB. Salvage of Severe Foot and Ankle Trauma With a 3D Printed Scaffold. Foot Ankle Int. 2016 Apr;37(4):433-9. doi: 10.1177/1071100715620895. Epub 2016 Jan 13. PMID: 26764314.

Dekker TJ, Steele JR, Federer AE, Hamid KS, Adams SB Jr. Use of Patient-Specific 3D-Printed Titanium Implants for Complex Foot and Ankle Limb Salvage, Deformity Correction, and Arthrodesis Procedures. Foot Ankle Int. 2018 Aug;39(8):916-921. doi: 10.1177/1071100718770133. Epub 2018 Apr 12. PMID: 29648876.

Shnol H, LaPorta GA. 3D Printed Total Talar Replacement: A Promising Treatment Option for Advanced Arthritis, Avascular Osteonecrosis, and Osteomyelitis of the Ankle. Clin Podiatr Med Surg. 2018 Oct;35(4):403-422. doi: 10.1016/j.cpm.2018.06.002. Epub 2018 Aug 14. PMID: 30223950.

Downloads

Published

2021-12-30

How to Cite

1.
Love E, Sansosti L, Labbad Z, Khurram, Alyssa, Priyanka, Sarah, Michael, Jessica, Griffin. 3D printing technology: Rethinking the approach to talar surgery; a literature review. J Int Foot Ankle [Internet]. 2021 Dec. 30 [cited 2022 Jan. 19];1(1). Available from: https://internationalfootankle.org/journal/index.php/JIFAF/article/view/3