Custom-Made Total Talonavicular Replacement in a Professional Rock Climber: Functional Evaluation With Gait Analysis and 3-Dimensional Medical Imaging in Weightbearing at 5 Years' Follow-Up.

With the goal to restore ankle and foot function also in the long term, custom-made prostheses are becoming more frequently possible solutions for severe bone loss and avascular necrosis of the talus. A young professional rock climber was implanted with a custom-made talonavicular prosthesis, and sh...

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Publicado en:Journal of Foot & Ankle Surgery Vol. 59; no. 5; pp. 1118 - 1128
Autores principales: Lullini, Giada, Belvedere, Claudio, Ortolani, Maurizio, Ruzzi, Silvia, Mazzotti, Antonio, Leardini, Alberto
Formato: case study tables/charts Journal Article
Publicado: W B Saunders Sep2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2020
      vid: 59
      iid: 5
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      pub: W B Saunders
      place: Philadelphia, Pennsylvania
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        145338072
        145338072
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        10.1053/j.jfas.2020.05.005
        145338072
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        atl: Custom-Made Total Talonavicular Replacement in a Professional Rock Climber: Functional Evaluation With Gait Analysis and 3-Dimensional Medical Imaging in Weightbearing at 5 Years' Follow-Up.
      aug:
        au:
          Lullini, Giada
          Belvedere, Claudio
          Ortolani, Maurizio
          Ruzzi, Silvia
          Mazzotti, Antonio
          Leardini, Alberto
        affil: Laboratory Physiatrist, Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
      sug:
        subj:
          Foot Fractures Surgery
          Prosthesis Design
          Gait Analysis
          Imaging, Three-Dimensional Methods
          Weight-Bearing
          Rock Climbing Injuries
          Athletes, Professional
          Male
          Adult
          Rock Climbing
          Fluoroscopy Evaluation
          Tomography, X-Ray Computed Methods
          Talus Injuries
          After Care
          Adult: 19-44 years
          Male
      ab: With the goal to restore ankle and foot function also in the long term, custom-made prostheses are becoming more frequently possible solutions for severe bone loss and avascular necrosis of the talus. A young professional rock climber was implanted with a custom-made talonavicular prosthesis, and short-term (30 months) assessment has been published. A thorough assessment at the intermediate term (60 months), with state-of-the-art gait and medical imaging analyses, is reported here. Level walking and more demanding motor tasks were analyzed with both a full-body and a multisegment foot protocol on the operated and contralateral limbs. Cone-beam computer-tomography was also used to obtain 3-dimensional (3D) position and orientation of bone models on the operated ankle. These models were also used for a 3D video fluoroscopy analysis, with the ankle in 3 joint positions at the extremes of motion. Distance map analysis was performed to check for possible changes over time of bone morphology and joint contact areas, in all 3 joint positions. Very satisfactory functional results were observed, with large and symmetric joint motion and physiological muscular recruitment even in demanding motor tasks. Distance map analyses revealed that very small morphologic and contact patterns changes occurred in the replaced ankle between 30 and 60 months. Concerns about possible wear of the cartilage in the tibial mortise are not yet supported by experimental evidence.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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