AIP Tech CJSC, 5/2 Paruyr Sevak, Yerevan, 0619, Armenia.
WIGMORE CLINIC CJSC, Yerevan, Armenia.
J Orthop Surg Res. 2024 Aug 22;19(1):501. doi: 10.1186/s13018-024-04948-w.
New technologies in additive manufacturing and patient-specific CT-based custom implant designs make it possible for previously unimaginable salvage and limb-sparing operations a practical reality. This study presents the design and fabrication of a lattice-structured implant for talus replacement surgery. Our primary case involved a young adult patient who had sustained severe damage to the talus, resulting in avascular necrosis and subsequent bone collapse. This condition caused persistent and debilitating pain, leading the medical team to consider amputation of the left foot at the ankle level as a last resort. Instead, we proposed a Ti6Al4V-based patient-specific implant with lattice structure specifically designed for pan-talar fusion. Finite element simulation is conducted to estimate its performance. To ensure its mechanical integrity, uniaxial compression experiments were conducted. The implant was produced using selective laser melting technology, which allowed for precise and accurate construction of the unique lattice structure. The patient underwent regular monitoring for a period of 24 months. At 2-years follow-up the patient successfully returned to activities without complication. The patient's functional status was improved, limb shortening was minimized.
新技术在增材制造和基于 CT 的个体化定制植入物设计方面取得了突破，使得以前难以想象的保肢和挽救手术成为现实。本研究介绍了一种用于距骨置换手术的晶格结构植入物的设计和制造。我们的主要病例涉及一位年轻的成年患者，他的距骨遭受了严重的损伤，导致了无菌性坏死和随后的骨塌陷。这种情况导致了持续的、使人衰弱的疼痛，使得医疗团队考虑将左脚踝截肢作为最后的手段。相反，我们提出了一种基于 Ti6Al4V 的个体化定制植入物，具有专门设计用于全距骨融合的晶格结构。进行有限元模拟以估计其性能。为了确保其机械完整性，进行了单轴压缩实验。该植入物采用选择性激光熔化技术制造，该技术允许对独特的晶格结构进行精确和准确的构建。患者接受了 24 个月的定期监测。在 2 年的随访中，患者成功地恢复了活动，没有并发症。患者的功能状态得到改善，肢体缩短最小化。
