Top

Journal of Orthopaedic Surgery and Research

Published in:

Open Access 01-12-2024 | Research article

Three-dimensional printed custom-made modular talus prosthesis in patients with talus malignant tumor resection

Authors: Xuanhong He, Minxun Lu, Chang Zou, Zhuangzhuang Li, Taojun Gong, Guy Romeo Kenmegne, Yitian Wang, Yi Luo, Yong Zhou, Li Min, Chongqi Tu

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2024

Abstract

Background

Talar malignant tumor is extremely rare. Currently, there are several alternative management options for talus malignant tumor including below-knee amputation, tibio-calcaneal arthrodesis, and homogenous bone transplant while their shortcomings limited the clinical application. Three-dimensional (3D) printed total talus prosthesis in talus lesion was reported as a useful method to reconstruct talus, however, most researches are case reports and its clinical effect remains unclear. Therefore, the current study was to explore the application of 3D printed custom-made modular prosthesis in talus malignant tumor.

Methods

We retrospectively analyzed the patients who received the 3D printed custom-made modular prosthesis treatment due to talus malignant tumor in our hospital from February 2016 to December 2021. The patient's clinical data such as oncology outcome, operation time, and volume of blood loss were recorded. The limb function was evaluated with the Musculoskeletal Tumor Society 93 (MSTS-93) score, The American Orthopedic Foot and Ankle Society (AOFAS) score; the ankle joint ranges of motion as well as the leg length discrepancy were evaluated. Plain radiography and Tomosynthesis-Shimadzu Metal Artefact Reduction Technology (T-SMART) were used to evaluate the position of prosthesis and the osseointegration. Postoperative complications were recorded.

Results

The average patients’ age and the follow-up period were respectively 31.5 ± 13.1 years; and 54.8 months (range 26–72). The medium operation time was 2.4 ± 0.5 h; the intraoperative blood loss was 131.7 ± 121.4 ml. The mean MSTS-93 and AOFAS score was 26.8 and 88.5 respectively. The average plantar flexion, dorsiflexion, varus, and valgus were 32.5, 9.2, 10.8, and 5.8 degree respectively. One patient had delayed postoperative wound healing. There was no leg length discrepancy observed in any patient and good osseointegration was observed on the interface between the bone and talus prosthesis in all subjects.

Conclusion

The modular structure of the prosthesis developed in this study seems to be convenient for prosthesis implantation and screws distribution. And the combination of solid and porous structure improves the initial stability and promotes bone integration. Therefore, 3D printed custom-made modular talus prosthesis could be an alternative option for talus reconstruction in talus malignant tumor patients.

Murari TM, Callaghan JJ, Berrey BH Jr, Sweet DE. Primary benign and malignant osseous neoplasms of the foot. Foot Ankle. 1989;10(2):68–80. https://doi.org/10.1177/107110078901000205.CrossRefPubMed

Patil S, de Silva MV, Crossan J, Reid R. Chondrosarcoma of the bones of the feet. J Foot Ankle Surg. 2003;42(5):290–5. https://doi.org/10.1016/s1067-2516(03)00306-5.CrossRefPubMed

Young PS, Bell SW, MacDuff EM, Mahendra A. Primary osseous tumors of the hindfoot: why the delay in diagnosis and should we be concerned? Clin Orthop Relat Res. 2013;471(3):871–7. https://doi.org/10.1007/s11999-012-2570-6.CrossRefPubMed

Özer D, Aycan OE, Er ST, Tanrıtanır R, Arıkan Y, Kabukçuoğlu YS. Primary tumor and tumor-like lesions of bones of the foot: single-center experience of 166 cases. J Foot Ankle Surg. 2017;56(6):1180–7. https://doi.org/10.1053/j.jfas.2017.05.027.CrossRefPubMed

Karakoç Y, Ulucaköy C. Management and retrospective analysis of tumors and tumor-like lesions localized in the talus. Joint Dis Relat Surg. 2021;32(1):218–23. https://doi.org/10.5606/ehc.2021.78769.CrossRef

Bakotic B, Huvos AG. Tumors of the bones of the feet: the clinicopathologic features of 150 cases. J Foot Ankle Surg. 2001;40(5):277–86. https://doi.org/10.1016/s1067-2516(01)80063-6.CrossRefPubMed

Bahamonde Munoz L, Escudero HM. Massive chondroblastoma of the talus: treatment with en bloc talectomy and tibiocalcaneal arthrodesis: long-term follow-up of a case. Foot Ankle Spec. 2017;10(3):274–7. https://doi.org/10.1177/1938640016676339.CrossRefPubMed

Papagelopoulos PJ, Sarlikiotis T, Vottis CT, Agrogiannis G, Kontogeorgakos VA, Savvidou OD. Total talectomy and reconstruction using a 3-dimensional printed talus prosthesis for Ewing’s sarcoma: a 3.5-year follow-up. Orthopedics. 2019;42(4):e405–9. https://doi.org/10.3928/01477447-20190523-05.CrossRefPubMed

Petrilli AS, Gentil FC, Epelman S, et al. Increased survival, limb preservation, and prognostic factors for osteosarcoma. Cancer. 1991;68(4):733–7. https://doi.org/10.1002/1097-0142(19910815)68:4%3c733::aid-cncr2820680412%3e3.0.co;2-0.CrossRefPubMed

10.

Hong AM, Millington S, Ahern V, et al. Limb preservation surgery with extracorporeal irradiation in the management of malignant bone tumor: the oncological outcomes of 101 patients. Ann Oncol. 2013;24(10):2676–80. https://doi.org/10.1093/annonc/mdt252.CrossRefPubMed

11.

Rochman R, Jackson Hutson J, Alade O. Tibiocalcaneal arthrodesis using the Ilizarov technique in the presence of bone loss and infection of the talus. Foot Ankle Int. 2008;29(10):1001–8. https://doi.org/10.3113/fai.2008.1001.CrossRefPubMed

12.

Myerson MS, Alvarez RG, Lam PW. Tibiocalcaneal arthrodesis for the management of severe ankle and hindfoot deformities. Foot Ankle Int. 2000;21(8):643–50. https://doi.org/10.1177/107110070002100803.CrossRefPubMed

13.

Reinke C, Lotzien S, Yilmaz E, et al. Tibiocalcaneal arthrodesis using the Ilizarov fixator in compromised hosts: an analysis of 19 patients. Arch Orthop Trauma Surg. 2022;142(7):1359–66. https://doi.org/10.1007/s00402-021-03751-0.CrossRefPubMed

14.

Miller CP, Chiodo CP. Autologous bone graft in foot and ankle surgery. Foot Ankle Clin. 2016;21(4):825–37. https://doi.org/10.1016/j.fcl.2016.07.007.CrossRefPubMed

15.

Baumhauer J, Pinzur MS, Donahue R, Beasley W, DiGiovanni C. Site selection and pain outcome after autologous bone graft harvest. Foot Ankle Int. 2014;35(2):104–7. https://doi.org/10.1177/1071100713511434.CrossRefPubMed

16.

Schmidt AH. Autologous bone graft: Is it still the gold standard? Injury. 2021;52(Suppl 2):S18-s22. https://doi.org/10.1016/j.injury.2021.01.043.CrossRefPubMed

17.

Angthong C, Rajbhandari P. Total talar prosthesis with and without ankle ligament reconstruction using the three-dimensional computer-aided design and computer numerical control manufacturing techniques. Orthop Rev. 2020;12(3):8844. https://doi.org/10.4081/or.2020.8844.CrossRef

18.

Huang J, Xie F, Tan X, Xing W, Zheng Y, Zeng C. Treatment of osteosarcoma of the talus with a 3D-printed talar prosthesis. J Foot Ankle Surg. 2021;60(1):194–8. https://doi.org/10.1053/j.jfas.2020.01.012.CrossRefPubMed

19.

Yang QD, Mu MD, Tao X, Tang KL. Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus: a case report and review of the literature. World J Clin Cases. 2021;9(13):3147–56. https://doi.org/10.12998/wjcc.v9.i13.3147.CrossRefPubMedPubMedCentral

20.

Angthong C. Anatomic total talar prosthesis replacement surgery and ankle arthroplasty: an early case series in Thailand. Orthop Rev. 2014;6(3):5486. https://doi.org/10.4081/or.2014.5486.CrossRef

21.

Regauer M, Lange M, Soldan K, et al. Development of an internally braced prosthesis for total talus replacement. World J Orthop. 2017;8(3):221–8. https://doi.org/10.5312/wjo.v8.i3.221.CrossRefPubMedPubMedCentral

22.

Taniguchi A, Takakura Y, Sugimoto K, et al. The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus. J Bone Joint Surg Br Vol. 2012;94(11):1529–33. https://doi.org/10.1302/0301-620x.94b11.29543.CrossRef

23.

Taniguchi A, Takakura Y, Tanaka Y, et al. An alumina ceramic total talar prosthesis for osteonecrosis of the talus. J Bone Joint Surg Am. 2015;97(16):1348–53. https://doi.org/10.2106/jbjs.n.01272.CrossRefPubMed

24.

Tracey J, Arora D, Gross CE, Parekh SG. Custom 3D-printed total talar prostheses restore normal joint anatomy throughout the hindfoot. Foot Ankle Spec. 2019;12(1):39–48. https://doi.org/10.1177/1938640018762567.CrossRefPubMed

25.

Harnroongroj T, Harnroongroj T. The talar body prosthesis: results at ten to thirty-six years of follow-up. J Bone Joint Surg Am. 2014;96(14):1211–8. https://doi.org/10.2106/jbjs.m.00377.CrossRefPubMed

26.

Ando Y, Yasui T, Isawa K, Tanaka S, Tanaka Y, Takakura Y. Total talar replacement for idiopathic necrosis of the talus: a case report. J Foot Ankle Surg. 2016;55(6):1292–6. https://doi.org/10.1053/j.jfas.2015.07.015.CrossRefPubMed

27.

Fang X, Liu H, Xiong Y, et al. Total talar replacement with a novel 3D printed modular prosthesis for tumors. Ther Clin Risk Manag. 2018;14:1897–905. https://doi.org/10.2147/tcrm.s172442.CrossRefPubMedPubMedCentral

28.

Bos GD, Esther RJ, Woll TS. Foot tumors: diagnosis and treatment. J Am Acad Orthop Surg. 2002;10(4):259–70. https://doi.org/10.5435/00124635-200207000-00004.CrossRefPubMed

29.

Kransdorf MJ. Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol. 1995;164(2):395–402. https://doi.org/10.2214/ajr.164.2.7839977.CrossRefPubMed

30.

Khal AA, Apostu D, Schiau C, Bejinariu N, Pesenti S, Jouve JL. Custom-made 3D-printed prosthesis after resection of a voluminous giant cell tumour recurrence in pelvis. Diagnostics (Basel, Switz). 2023. https://doi.org/10.3390/diagnostics13030485.CrossRef

31.

Dennis MD, Tullos HS. Blair tibiotalar arthrodesis for injuries to the talus. J Bone Joint Surg Am. 1980;62(1):103–7.CrossRefPubMed

32.

Dennison MG, Pool RD, Simonis RB, Singh BS. Tibiocalcaneal fusion for avascular necrosis of the talus. J Bone Joint Surg Br Vol. 2001;83(2):199–203. https://doi.org/10.1302/0301-620x.83b2.11500.CrossRef

33.

Mann RA, Chou LB. Tibiocalcaneal arthrodesis. Foot Ankle Int. 1995;16(7):401–5. https://doi.org/10.1177/107110079501600704.CrossRefPubMed

34.

Wang J, Min L, Lu M, et al. Three-dimensional-printed custom-made hemipelvic endoprosthesis for the revision of the aseptic loosening and fracture of modular hemipelvic endoprosthesis: a pilot study. BMC Surg. 2021;21(1):262. https://doi.org/10.1186/s12893-021-01257-5.CrossRefPubMedPubMedCentral

35.

Wang J, Min L, Lu M, et al. What are the complications of three-dimensionally printed, custom-made, integrative hemipelvic endoprostheses in patients with primary malignancies involving the acetabulum, and what is the function of these patients? Clin Orthop Relat Res. 2020;478(11):2487–501. https://doi.org/10.1097/corr.0000000000001297.CrossRefPubMedPubMedCentral

36.

Buza JA 3rd, Leucht P. Fractures of the talus: current concepts and new developments. Foot Ankle Surg. 2018;24(4):282–90. https://doi.org/10.1016/j.fas.2017.04.008.CrossRefPubMed

37.

Ruatti S, Corbet C, Boudissa M, et al. Total talar prosthesis replacement after talar extrusion. J Foot Ankle Surg. 2017;56(4):905–9. https://doi.org/10.1053/j.jfas.2017.04.005.CrossRefPubMed

38.

Stevens BW, Dolan CM, Anderson JG, Bukrey CD. Custom talar prosthesis after open talar extrusion in a pediatric patient. Foot Ankle Int. 2007;28(8):933–8. https://doi.org/10.3113/fai.2007.0933.CrossRefPubMed

39.

Chaudhary SD, Agrawal PS, Sakharkar NS. Giant cell tumor of talus: a case report. J Orthop Case Rep. 2022;12(9):92–4. https://doi.org/10.13107/jocr.2022.v12.i09.3332.CrossRefPubMedPubMedCentral

40.

Tupe R, Panchwagh Y, Bartakke G, Puranik R, Waghchoure C. A rare cause of ankle pain—chondrosarcoma of the talus: a case report and literature review. J Orthop Case Rep. 2022;12(8):70–4. https://doi.org/10.13107/jocr.2022.v12.i08.2970.CrossRefPubMedPubMedCentral

41.

Sanchez-Sotelo J, Baghdadi YM, Morrey BF. Primary linked semiconstrained total elbow arthroplasty for rheumatoid arthritis: a single-institution experience with 461 elbows over three decades. J Bone Joint Surg Am. 2016;98(20):1741–8. https://doi.org/10.2106/jbjs.15.00649.CrossRefPubMedPubMedCentral

42.

Smida M, Ammar A, Fedhila F, Douira W, Sassi S. Periosteal preservation: a new technique in resection of bone high-grade malignant tumors in children-about eleven cases. World J Surg Oncol. 2022;20(1):312. https://doi.org/10.1186/s12957-022-02749-1.CrossRefPubMedPubMedCentral

43.

Tsukamoto S, Mavrogenis AF, Honoki K, et al. Reconstruction after talar tumor resection: a systematic review. Curr Oncol (Tor, Ont). 2022;29(12):9788–800. https://doi.org/10.3390/curroncol29120769.CrossRef

Title: Three-dimensional printed custom-made modular talus prosthesis in patients with talus malignant tumor resection
Authors: Xuanhong He
Minxun Lu
Chang Zou
Zhuangzhuang Li
Taojun Gong
Guy Romeo Kenmegne
Yitian Wang
Yi Luo
Yong Zhou
Li Min
Chongqi Tu
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2024
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-024-04728-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Three-dimensional printed custom-made modular talus prosthesis in patients with talus malignant tumor resection

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2024

Risk factors and prognosis of postoperative acute myocardial infarction in elderly hip fracture patients combined with coronary heart disease

Is fracture management merely a physical process? Exploring the psychological effects of internal and external fixation

Osteofibrous dysplasia: a narrative review

Optimal analgesic regimen for total shoulder arthroplasty: a randomized controlled trial and network meta-analysis

Clinical efficacy of percutaneous endoscopic posterior lumbar interbody fusion and modified posterior lumbar interbody fusion in the treatment of lumbar degenerative disease

Effect of bone marrow aspiration concentrate and platelet-rich plasma combination in anterior cruciate ligament reconstruction: a randomized, prospective, double-blinded study