Custom-made total ankle arthroplasty with patient-specific instrumentation for severe bone loss conditions: a case series

Eur J Orthop Surg Traumatol. 2024 Jan;34(1):379-387. doi: 10.1007/s00590-023-03658-z. Epub 2023 Aug 4.

Abstract

Purpose: Management of bone loss around the ankle is a challenging condition. This retrospective study describes the design process, the surgical technique, and the preliminary results of custom-made total ankle arthroplasties (TAA) with patient-specific instrumentation (PSI) for different severe bone loss conditions.

Methods: Consecutive patients that underwent custom-made TAA for severe bone loss conditions were included. The primary outcome was to describe the implant design in relation to the bone defect. Moreover, pre-operative and final follow-up clinical scores were compared.

Results: Seven patients were included. Post-operative radiographs showed good correspondence between the pre-operative planning and the prosthesis alignment in all patients. Improvement in clinical scores was observed in all patients at the final follow-up. One patient developed a deep infection.

Conclusion: Short-term results reported herein are encouraging suggesting that custom-made TAA implants with PSI may represent an effective solution for ankle bone loss conditions.

Keywords: 3D printing; Custom-made implants; Patient-specific instrumentation; Total ankle arthroplasty; Total talus replacement.

MeSH terms

  • Ankle / surgery
  • Ankle Joint / diagnostic imaging
  • Ankle Joint / surgery
  • Arthroplasty, Replacement, Ankle*
  • Humans
  • Joint Prosthesis*
  • Retrospective Studies