Salvage arthrodesis of a failed total ankle replacement using a custom 3D-printed cage implant: A case report and review of the literature

Abstract

We present a case report of a 66-year-old female who underwent salvage arthrodesis after a failed Scandinavian Total Ankle Replacement secondary to aseptic loosening and talar subsidence. Secondary to the loss of talar integrity the decision was made to proceed with revisional ankle arthrodesis. To maintain limb length the primary surgeon (EH) elected to use a custom cage implant in combination with an intramedullary nail construct in a single stage approach. The custom cage was augmented with autograft & allograft cancellous bone in addition to allograft recombinant human bone morphogenic protein, and allograft adult mesenchymal stem cells. The incision sites healed post-operatively without incident and at post-op week 16 the patient progressed to full unrestricted weight bearing in normal shoe wear with a gauntlet ankle brace. Although an isolated report, this case shows promise for further development of the technique. We believe this revisional arthrodesis technique warrants further research and consideration as a potential addition to the failed total ankle arthroplasty treatment algorithm.

Lower Limb Salvage Using Patent-Specific 3D-Printed Titanium Cage Following Severe Left Ankle Traumatic Partial Amputation: A Pediatric Case Report

“…Few clinical reports have been published on this technique. 2,8,9 In this report, we present the case of a 16-year-old female who suffered a traumatic partial amputation of her left distal lower extremity following an all-terrain vehicle (ATV) accident that resulted in a 10 × 10 cm skin laceration, and a 5 cm subsegmental bony loss of the distal tibia. She was successfully treated using a patient-specific 3D printed titanium truss cage in conjunction with a TTC arthrodesis using a retrograde nail.…”