Jennison Toby, Dalgleish James, Sharpe Ian, Davies Mark, Goldberg Andrew
Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom.
Sheffield Teaching Hospitals NHS Foundation Trust, Broomhall, Sheffield, United Kingdom.
Foot Ankle Orthop. 2023 Jan 27;8(1):24730114221151068. doi: 10.1177/24730114221151068. eCollection 2023 Jan.
Total talus replacements are a surgical treatment for talar avascular necrosis (AVN) replacing the entire talus. The potential for total talus replacements has increased with the advent of patient-specific implants using 3D printing based on computed tomographic scanning of the ipsilateral or contralateral talus. The primary aim of this review is to summarize the literature on total talus replacements, providing a historical survey, indications, controversies, complications, survival, and functional outcomes.
A systematic review was performed. Articles with survival of total talus replacements were included. Basic percentages and a critical review of the literature was performed.
Nine articles with 115 patients were included. The mean age ranged from 27.6 to 72 years, but with 5 studies having a mean age of <50 years. Mean follow-up ranged from 12.8 to 152 months. The most common indication was avascular necrosis in 67 patients (58%). Five studies used customized implants and 4 studies used 3D printing. Four studies used ceramic prostheses, 3 cobalt chromium, 1 stainless steel, and 1 titanium with ceramic surface. Three studies involved a talus replacement in conjunction with an ankle replacement. Postoperative complications ranged from 0% to 33%. Of 24 functional outcomes scores, 66.7% demonstrated significant improvement.
Total talus replacements are a promising alternative to tibiotalocalcaneal fusion for patients with avascular necrosis of the talus; however, further studies are required to ensure reliable outcomes prior to widespread adoption of this technology.
Level IV, review of case series.
全距骨置换术是一种用于距骨缺血性坏死（AVN）的外科治疗方法，可替换整个距骨。随着基于同侧或对侧距骨计算机断层扫描的3D打印个性化植入物的出现，全距骨置换术的潜力有所增加。本综述的主要目的是总结全距骨置换术的相关文献，提供历史回顾、适应症、争议、并发症、生存率和功能结果。
进行了一项系统综述。纳入了有关全距骨置换术生存率的文章。计算了基本百分比并对文献进行了批判性综述。
纳入了9篇文章，共115例患者。平均年龄在27.6岁至72岁之间，但有5项研究的平均年龄小于50岁。平均随访时间为12.8至152个月。最常见的适应症是67例（58%）患者的缺血性坏死。5项研究使用了定制植入物，4项研究使用了3D打印。4项研究使用了陶瓷假体，3项使用钴铬合金，1项使用不锈钢，1项使用表面为陶瓷的钛合金。3项研究涉及距骨置换联合踝关节置换。术后并发症发生率从0%到33%不等。在24项功能结果评分中，66.7%显示有显著改善。
对于距骨缺血性坏死患者，全距骨置换术是胫距跟融合术的一种有前景的替代方法；然而，在广泛采用这项技术之前，还需要进一步研究以确保可靠的结果。
IV级，病例系列综述。
