1st Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna, 40123, Bologna, Italy.
Eur J Orthop Surg Traumatol. 2024 Jan;34(1):379-387. doi: 10.1007/s00590-023-03658-z. Epub 2023 Aug 4.
Management of bone loss around the ankle is a challenging condition. This retrospective study describes the design process, the surgical technique, and the preliminary results of custom-made total ankle arthroplasties (TAA) with patient-specific instrumentation (PSI) for different severe bone loss conditions.
Consecutive patients that underwent custom-made TAA for severe bone loss conditions were included. The primary outcome was to describe the implant design in relation to the bone defect. Moreover, pre-operative and final follow-up clinical scores were compared.
Seven patients were included. Post-operative radiographs showed good correspondence between the pre-operative planning and the prosthesis alignment in all patients. Improvement in clinical scores was observed in all patients at the final follow-up. One patient developed a deep infection.
Short-term results reported herein are encouraging suggesting that custom-made TAA implants with PSI may represent an effective solution for ankle bone loss conditions.
踝关节周围骨丢失的管理是一项具有挑战性的难题。本回顾性研究描述了定制式全踝关节置换术（TAA）与患者特异性器械（PSI）的设计过程、手术技术，以及针对不同严重骨丢失情况的初步结果。
连续纳入接受定制式 TAA 治疗严重骨丢失情况的患者。主要结果是描述与骨缺损相关的植入物设计。此外，还比较了术前和最终随访的临床评分。
7 名患者纳入研究。术后 X 射线显示，所有患者的术前规划与假体对线之间具有良好的对应关系。所有患者在最终随访时的临床评分均得到改善。1 例患者发生深部感染。
本文报道的短期结果令人鼓舞，提示 PSI 定制式 TAA 植入物可能是治疗踝关节骨丢失的有效方法。
