Use of Patient-Specific 3D-Printed Titanium Implants for Complex Foot and Ankle Limb Salvage, Deformity Correction, and Arthrodesis Procedures

Dekker, Travis J.; Steele, John R.; Federer, Andrew E.; Hamid, Kamran S.; Adams, Samuel B.

doi:10.1177/1071100718770133

Cited by 102 publications

(73 citation statements)

References 12 publications

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“…The 3D printed titanium scaffolds used were manufactured by 4WEB Medical (Frisco, TX). These implants are 3D printed to meet the patient-specific anatomic needs for their bone loss based on computed tomography (CT) scan and have been previously described in the literature for other purposes (5,6). The spherical implants were designed with a cannulated center to allow passage of the TTC nail.…”

Section: Methodsmentioning

confidence: 99%

“…To combat these complications associated with large bulk allografts, TTC arthrodesis with custom 3-dimensional (3D) printed titanium implants has been performed in the setting of large bony defects. There have been case reports and small case series detailing the successful use of 3D printed custom implants in a variety of settings for hindfoot fusions, deformity corrections, and trauma (5)(6)(7). Most of these 3D implants have been designed for "flat" cuts or are completely conforming to the native bone architecture at the arthrodesis site.…”

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confidence: 99%

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Comparison of 3D Printed Spherical Implants versus Femoral Head Allografts for Tibiotalocalcaneal Arthrodesis

Steele

Kadakia

Cunningham

et al. 2020

The Journal of Foot and Ankle Surgery

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Successful tibiotalocalcaneal (TTC) arthrodesis can be difficult to achieve in patients with bulk bone defects even with the use of femoral head allograft. Retrograde intramedullary nail placement through custom 3-dimensional (3D) spherical implants is an innovative option for these patients. The purpose of this study was to compare fusion rates, graft resorption, and complication rates between patients undergoing TTC fusion with 3D sphere implants versus femoral head allografts. Patients who underwent TTC arthrodesis with an intramedullary nail along with a 3D spherical implant (n = 8) or femoral head allograft (n = 7) were included in this study. The rate of successful fusion of the tibia, calcaneus, and talar neck to the 3D sphere or femoral head allograft was compared between the groups. The rate of total fused articulations was significantly higher in the 3D sphere group (92%) than the femoral head allograft group (62%; p = .018). The number of patients achieving successful fusion of all 3 articulations was higher in the 3D sphere group (75%) than the femoral head allograft group (42.9%, p = .22). The rate of graft resorption was significantly higher in the femoral head allograft group (57.1%) than the 3D sphere group (0%, p = .016). There were no significant differences between the groups in terms of complications. These data demonstrate that the use of a custom 3D printed sphere implant is safe in patients with severe bone loss undergoing TTC arthrodesis with a retrograde intramedullary nail and may result in improved rates of successful arthrodesis.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Comparison of 3D Printed Spherical Implants versus Femoral Head Allografts for Tibiotalocalcaneal Arthrodesis

Steele

Kadakia

Cunningham

et al. 2020

The Journal of Foot and Ankle Surgery

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“…A number of various techniques were proposed to achieve ankle arthrodesis, among them external and internal stabilization [ 14 – 16 , 18 , 20 , 22 , 23 , 25 , 26 ]. Outcomes of ankle arthrodesis vary depending on the stabilization technique [ 14 , 22 , 24 , 26 – 30 ].…”

Section: Introductionmentioning

confidence: 99%

Pedobarographic analysis of body weight distribution on the lower limbs and balance after ankle arthrodesis with Ilizarov fixation and internal fixation

et al. 2018

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BackgroundA number of various techniques were proposed to stabilized ankle arthrodesis, among them external and internal fixation. Appropriate balance and adequate distribution of lower limb loads determine normal biomechanics of the locomotor system. We hypothesized that various techniques used to stabilize ankle arthrodesis may exert different effects on (1) balance and (2) distribution of lower limb loads.MethodsRetrospective analysis included 47 patients who underwent ankle arthrodesis with external stabilization with Ilizarov fixator (group 1, n = 21) or internal stabilization with screws (group 2, n = 26) between 2007 and 2015. Balance and distribution of lower limb loads were determined with a pedobarographic platform.ResultsIn group 1, average load of the operated and non-operated limb amounted to 48.8% and 51.2%, respectively, and in group subjected to internal stabilization to 48.4% and 51.6%, respectively. Neither the intragroup nor the intergroup differences in the distribution of lower limb loads were statistically significant. Mean length of the center of gravity (COG) path was 137.9 cm for group 1 and 134 cm for group 2, and mean COG area amounted to 7.41 cm2 and 6.16 cm2, respectively. The latter intergroup difference was statistically significant.ConclusionsBalance after ankle arthrodesis with Ilizarov fixation is worse than after the same procedure with internal stabilization. Despite correction of ankle deformity, musculoskeletal biomechanics still remains impaired. While ankle fusion with either Ilizarov or internal fixation provide appropriate distribution of lower limb loads, none of these procedures normalize patients’ balance.

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“…This is evident by the advances in total ankle replacement surgery [1], replacement surgery using total artificial tali [2], and arthroscopic surgery [3]. Such substantial technological progress in foot and ankle surgery has been made possible by the knowledge gained from morphological research in technologies such as computed tomography (CT) [4], threedimensional (3D) printing technology [5], and computer-aided design programs, which transform CT images into 3D images [2]. These advanced technologies have led to developments in cutting-edge orthopedic surgery, such as the successful use of patient-specific 3D-printed titanium implants for the treatment of complex large bony defects and deformities and for use in arthrodesis procedures [5].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Background Little is known about differences in the size and morphology of the right and left human tali. The present study demonstrates differences between right and left talar morphometric geometric profiles as fluctuating asymmetry in matched pairs of cadaveric specimens. Methods In total, 24 tali were collected in this study. All eligible tali were systematically measured with a Vernier caliper and three-dimensional laser scanner, which provided data for further analysis regarding the talar morphometric geometric profiles. Data were calculated to demonstrate differences between the right and left talar profiles using a matched-pair method, including the general size of the talus. Results The average talar length was 53.5 mm, the average talar dome height was 31.2 mm, and the average talar body width was 41.3 mm. The average anterior trochlear width, middle trochlear width, posterior trochlear width, and trochlear length were 31.8, 31.2, 28.3, and 30.7 mm, respectively. Eleven matched pairs of intact tali were eligible for the matched-pair study. Paired t-tests showed significant differences in the talar dome height (P = 0.019), middle trochlear width (P = 0.027), and posterior trochlear width (P = 0.016) between the right

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Use of Patient-Specific 3D-Printed Titanium Implants for Complex Foot and Ankle Limb Salvage, Deformity Correction, and Arthrodesis Procedures

Abstract: Level IV, retrospective case series.

Cited by 102 publications

References 12 publications

Comparison of 3D Printed Spherical Implants versus Femoral Head Allografts for Tibiotalocalcaneal Arthrodesis

Comparison of 3D Printed Spherical Implants versus Femoral Head Allografts for Tibiotalocalcaneal Arthrodesis

Pedobarographic analysis of body weight distribution on the lower limbs and balance after ankle arthrodesis with Ilizarov fixation and internal fixation

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

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