Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: A case report and review of the literature

Abstract

BACKGROUND Giant cell tumors (GCT) are most commonly seen in the distal femur. These tumors are uncommon in the small bones of the hand and feet, and a very few cases have been reported. A giant cell tumor of the talus is rarely seen clinically and could be a challenge to physicians. CASE SUMMARY We report a rare case of GCT of the talus in one patient who underwent a new reconstructive surgery technique using a three-dimensional (3D) printing talar prosthesis. The prosthesis shape was designed by tomographic image processing and segmentation using technology to match the intact side by mirror symmetry with 3D post-processing technologies. The patient recovered nearly full range of motion of the ankle after 6 mo. The visual analogue scale and American Orthopaedic Foot and Ankle Society scores were 1 and 89 points, respectively. CONCLUSION We demonstrated that 3D printing of a talar prosthesis is a beneficial option for GCT of the talus.

Reconstruction after Talar Tumor Resection: A Systematic Review

“…The mean ankle joint ROM in plantar/dorsiflexion in the tibiocalcaneal fusion group was 32.5 (range 30–35) [ 18 , 19 ], while that of the talar prosthesis group was 36.7 (range 25–45; Table 3 ) [ 11 , 24 , 30 ]. The mean AOFAS score in the tibiocalcaneal fusion group was 77 (range 71–83) [ 25 , 28 ], while that of the talar prosthesis group was 89 (range 86–91) [ 11 , 24 , 30 ]. The AOFAS score was higher in the group reconstructed using a talar prosthesis ( Table 3 ).…”

“…The mean leg length difference was 0.4 cm (range 0–1.5 cm) in the tibiocalcaneal fusion group [ 10 , 13 , 18 , 28 ] and 0 cm in the talar prosthesis and frozen autograft groups ( Table 3 ) [ 8 , 11 , 12 , 23 , 24 , 30 ]. The mean leg length difference in the tibiocalcaneal fusion group treated with an autograft or allograft was 0.2 cm (range 0–1 cm) [ 10 , 13 , 28 ], whereas that in the tibiocalcaneal fusion group treated without an autograft or allograft was 1.5 cm [ 18 ] ( Table 2 ).…”

“…Of the 156 studies identified in the search, 20 were finally included ( Figure 1 ; Table 1 , Table 2 and Table 3 ) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 28 , 29 , 30 ]. There were no RCTs among them.…”

“…Patients with sarcoma of the lower extremities who undergo limb salvage reportedly have higher Musculoskeletal Tumor Society (MSTS) scores than those who undergo amputation [ 14 , 15 , 16 ]. In patients with intermediate-grade tumors, such as osteoblastoma, giant cell tumor of the bone, epithelioid hemangioma or desmoplastic fibroma with large extraskeletal lesions, poor residual cortical bone, and curettage difficulty, marginal tumor resection is required [ 6 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. A variety of reconstruction techniques have been described for treating bone defects after talar tumor resection, including tibiocalcaneal fusion [ 7 , 9 , 10 , 13 , 17 , 18 , 19 , 20 , 21 , 22 , 25 , 27 , 28 , 29 ], reconstruction with a frozen autograft [ 8 ], and talar prostheses [ 11 , 12 , 23 , 24 , 30 ].…”

“…In patients with intermediate-grade tumors, such as osteoblastoma, giant cell tumor of the bone, epithelioid hemangioma or desmoplastic fibroma with large extraskeletal lesions, poor residual cortical bone, and curettage difficulty, marginal tumor resection is required [ 6 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. A variety of reconstruction techniques have been described for treating bone defects after talar tumor resection, including tibiocalcaneal fusion [ 7 , 9 , 10 , 13 , 17 , 18 , 19 , 20 , 21 , 22 , 25 , 27 , 28 , 29 ], reconstruction with a frozen autograft [ 8 ], and talar prostheses [ 11 , 12 , 23 , 24 , 30 ]. However, owing to their rarity, the results of each reconstruction method are not well known as they are mostly case reports.…”