An Alumina Ceramic Total Talar Prosthesis for Osteonecrosis of the Talus

Abstract

Background: Treatment of osteonecrosis of the talus is challenging. Total talar replacement has the potential to restore the function of the ankle joint without an associated leg-length discrepancy. The purpose of the present study was to investigate postoperative function and pain after total talar replacement in patients with osteonecrosis of the talus.Methods: Fifty-five ankles in fifty-one consecutive patients with osteonecrosis of the talus who were treated with a total talar replacement from 2005 to 2012 were included in the investigation. Scores according to the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and the Ankle Osteoarthritis Scale (AOS) were assessed before surgery and at the final follow-up evaluation.Results: According to the JSSF ankle-hindfoot scale, the score for pain improved from a mean (and standard deviation) of 15 ± 9.4 points (range, 0 to 20 points) to 34 ± 5.6 points (range, 20 to 40 points); the score for function, from 21.2 ± 9.7 points (range, 4 to 38 points) to 45.1 ± 4.0 points (range, 37 to 50 points); the score for alignment, from 6.0 ± 2.8 points (range, 5 to 10 points) to 9.8 ± 0.9 points (range, 5 to 10 points); and the total score, from 43.1 ± 17.0 points (range, 11 to 68 points) to 89.4 ± 8.4 points (range, 76 to 100 points). According to the AOS scale, the score for "pain at its worst" improved from a mean of 6.1 ± 3.3 points (range, 0 to 9.9 points) to 2.0 ± 1.7 points (range, 0 to 6.3 points).Conclusions: Prosthetic talar replacement is a useful procedure for patients with osteonecrosis of the talus as it maintains ankle function.

Total talar replacement with a novel 3D printed modular prosthesis for tumors

“…Total talar replacement with a prosthesis, first performed by Taniguchi et al in 2005, is considered to be an optimal treatment for extensive aseptic necrosis of the talus, and traumatic loss of talus. 10 Preservation of the joint motion and shorter recovery are the major advantages over traditional surgical options. And we believe it would also be of significance in treating talus tumors.…”

Custom-Made Alumina Ceramic Total Talar Prosthesis for Idiopathic Aseptic Necrosis of the Talus: Report of Two Cases

“…Both were found to have an acceptable clinical outcome but also caused a few problems. Taniguchi et al voiced concern about loosening and sinking between the talar body prosthesis and the talar neck [6] and recommended using a third-generation prosthesis that completely replaces the talus [7]. As in our two cases, Ando et al found that total replacement with a third-generation talar prosthesis for necrosis of the talus achieved a much better outcome in a 72-year-old woman at 2 years after surgery [23].…”

“…Taniguchi et al [7] and Ando et al [23] have reported that total talar replacement with an alumina ceramic prosthesis is the most suitable treatment for necrosis of the talar body. In their cases, patients proceeded to early rehabilitation after surgery with improved range of motion at the ankle and pain-free walking.…”

“…A total talar prosthesis that was developed and refined in Japan has had excellent postoperative outcomes [5–7]. However, to our knowledge, there are few reports of the use of a third-generation alumina ceramic talar prosthesis for necrosis of the talus.…”

Morphometric geometric differences between right and left human tali: A cadaveric study of fluctuating asymmetry via systematic measurement and three-dimensional scanning

“…Several ligaments attach the talus to its surrounding articular structures [12]. Based on these exclusive characteristics, the talus is prone to several pathologies and injuries, but the native talus is difficult to reconstruct or duplicate in patients with conditions such as peritalar instability [13], talar bone damage [14], and loss of the talus [2]. Several reports have proposed the characteristics of the talus in terms of its biomechanical and morphologic aspects.…”