Mitra Kishen, Movva Arun K, Sohn Michael O, Tennyson Joshua M, Talaski Grayson M, Adams Samuel B, Anastasio Albert T
Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA.
Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Materials (Basel). 2025 Aug 11;18(16):3770. doi: 10.3390/ma18163770.
Total ankle arthroplasty (TAA) has evolved significantly through advances in alloy selection and manufacturing technologies. This narrative review examines the metallurgical foundations of contemporary TAA implants, analyzing primary alloy systems and their mechanical properties. Cobalt-chromium alloys provide superior mechanical strength and durability but present metal ion release concerns, while titanium alloys (Ti6Al4V) optimize biocompatibility with elastic modulus values (101-113 GPa) closer to bone, despite tribological limitations. Novel β-titanium formulations (Ti-35Nb-7Zr-5Ta, Ti10Mo6Zr4Sn3Nb) eliminate toxic aluminum and vanadium components while achieving lower elastic modulus values (50-85 GPa) that better match cortical bone properties. Manufacturing has transitioned from traditional methods (investment casting, forging, CNC machining) toward additive manufacturing technologies. Selective laser melting and electron beam melting enable patient-specific geometries, controlled porosity, and optimized microstructures, though challenges remain with residual stresses, surface finish requirements, and post-processing needs. Emerging biodegradable materials, composite structures, and hybrid implant designs represent promising future directions for addressing current material limitations. This review provides evidence-based insights for alloy selection and manufacturing approaches, emphasizing the critical role of materials engineering in TAA implant performance and clinical outcomes.
全踝关节置换术（TAA）通过合金选择和制造技术的进步得到了显著发展。这篇叙述性综述探讨了当代TAA植入物的冶金基础，分析了主要合金系统及其机械性能。钴铬合金具有卓越的机械强度和耐久性，但存在金属离子释放问题；而钛合金（Ti6Al4V）优化了生物相容性，其弹性模量值（101 - 113 GPa）更接近骨骼，尽管存在摩擦学限制。新型β钛配方（Ti - 35Nb - 7Zr - 5Ta、Ti10Mo6Zr4Sn3Nb）消除了有毒的铝和钒成分，同时实现了更低的弹性模量值（50 - 85 GPa），能更好地匹配皮质骨特性。制造方式已从传统方法（熔模铸造、锻造、数控加工）向增材制造技术转变。选择性激光熔化和电子束熔化能够实现针对患者的特定几何形状、可控孔隙率和优化的微观结构，不过在残余应力、表面光洁度要求和后处理需求方面仍存在挑战。新兴的可生物降解材料、复合结构和混合植入物设计代表了解决当前材料局限性的有前景的未来方向。本综述为合金选择和制造方法提供了基于证据的见解，强调了材料工程在TAA植入物性能和临床结果中的关键作用。
