Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
Department of Orthopaedics and Physical Medicine, Medical University of South Carolina, Charleston, SC, USA.
Foot Ankle Int. 2022 Feb;43(2):291-302. doi: 10.1177/10711007211051013. Epub 2021 Nov 10.
Avascular osteonecrosis (AVN) of the talus (AVNT) is a painful and challenging clinical diagnosis. AVNT has multiple known risk factors and etiologies and presents at different stages in severity. Given these unique factors, the optimal treatment solution has yet to be determined. Both joint-preserving and joint-sacrificing procedures are available, including core decompression and arthrodeses. Recently, new salvage and replacement techniques have been described including vascularized pedicle bone grafts and total talus replacement using patient-specific prosthesis; however, evidence remains limited. This review examines the current trends AVNT treatment and the emerging data behind these novel techniques.
距骨缺血性坏死（AVN）是一种痛苦且具有挑战性的临床诊断。AVNT 有多种已知的风险因素和病因，并在严重程度的不同阶段表现出来。鉴于这些独特的因素，最佳的治疗方案尚未确定。既有关节保存和关节牺牲手术可供选择，包括核心减压和关节融合术。最近，已经描述了新的挽救和替代技术，包括带血管蒂骨瓣移植和使用患者特异性假体的全距骨置换术；然而，证据仍然有限。本综述检查了目前 AVNT 治疗的趋势和这些新技术背后的新兴数据。
