Tibiotalocalcaneal Arthrodesis for Severe Talar Avascular Necrosis

Foot Ankle Clin. 2019 Mar;24(1):143-161. doi: 10.1016/j.fcl.2018.11.002.

Abstract

Severe talar avascular necrosis has many etiologies and can cause bone loss/hindfoot deformity. Tibiotalar calcaneal arthrodesis is a salvage procedure after severe talar avascular necrosis. Large bone voids can present significant challenges. Modest successes have been reported with structural block allograft tibiotalocalcaneal arthrodesis using either plate and screws, intramedullary nail fixation, or a combination. The advent of 3-dimensional printed titanium trusses has given surgeons another option for filling voids and providing structural support to prevent collapse. Although these options expand the armamentarium, treating surgeons must adhere to principles of arthrodesis: stable constructs, thorough joint surface preparation, and correction of deformity.

Keywords: 3-D printed cage; 3-D printed truss; Allograft bone block; Avascular necrosis of the talus; Talar collapse; Tibiotalocalcaneal arthrodesis.

Publication types

  • Review

MeSH terms

  • Adult
  • Ankle Joint / pathology
  • Ankle Joint / surgery*
  • Arthrodesis / methods*
  • Calcaneus / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteonecrosis / surgery*
  • Printing, Three-Dimensional
  • Prostheses and Implants / adverse effects
  • Talus / pathology
  • Talus / surgery*