Custom Patient-Specific 3D-Printed Titanium Truss Tibiotalocalcaneal Arthrodesis Implants for Failed Total Ankle Replacements: Classification, Technical Tips, and Treatment Algorithm.

Background: The management of failed total ankle replacements, with significant loss of bone stock, is challenging with high rates of complications and associated morbidity. Recent technological advances have enabled the development of patient-customized 3D-printed titanium truss arthrodesis implant...

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Publicado en:Foot & Ankle International Vol. 45; no. 9; pp. 950 - 962
Autores principales: Lewis, Thomas L., Walker, Roland, Alkhalfan, Yousif, Latif, Ahmed, Abbasian, Ali
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Sage Publications Inc. Sep2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2024
      vid: 45
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Custom Patient-Specific 3D-Printed Titanium Truss Tibiotalocalcaneal Arthrodesis Implants for Failed Total Ankle Replacements: Classification, Technical Tips, and Treatment Algorithm.
      aug:
        au:
          Lewis, Thomas L.
          Walker, Roland
          Alkhalfan, Yousif
          Latif, Ahmed
          Abbasian, Ali
        affil: Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
      sug:
        subj:
          Arthroplasty, Replacement, Ankle Adverse Effects
          Arthrodesis Methods
          Reoperation
          Prostheses and Implants Equipment and Supplies
          Arthrodesis Equipment and Supplies
          Treatment Outcomes
          Human
          Prospective Studies
          Nonexperimental Studies
          Descriptive Statistics
          Data Analysis Software
          Tertiary Health Care United Kingdom
          United Kingdom
          Algorithms
          T-Tests
          Male
          Female
          Middle Age
          Aged
          Aged, 80 and Over
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background: The management of failed total ankle replacements, with significant loss of bone stock, is challenging with high rates of complications and associated morbidity. Recent technological advances have enabled the development of patient-customized 3D-printed titanium truss arthrodesis implants, which offer an alternative salvage option for failed total ankle replacements. Methods: A prospective observational study was performed of 6 cases of failed total ankle replacements that were managed using custom patient-specific 3D-printed titanium truss arthrodesis implants. Technical tips, classification, and a treatment algorithm were developed based on our initial experience. Results: Between November 2018 and March 2022, 6 patients underwent arthrodesis for failed total ankle replacements. Follow-up was available for all cases. The mean follow-up was 3.0 years (range 1-4.5). The mean MOXFQ Index improved from 73.1 to 32.3 (P <.05). The mean EQ-5D-5L Index improved from 0.366 to 0.743 (P <.05) and the EQ-VAS also improved from 53.0 to 63.3 (P =.36). The mean VAS-Pain score at final follow-up was 27.5. There were no cases of nonunion. None of the patients were smokers. The overall complication rate was 50%. Two patients returned to surgery: one for wound washout following TAR explantation and a second for removal of metalwork 2 years following surgery for a prosthetic joint infection secondary to hematogenous spread. No patients underwent revision fixation or amputation. Conclusion: Custom patient-specific 3D-printed titanium truss arthrodesis implants are a viable treatment option for failed total ankle replacements.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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