Zou Zhi, Xu Chuntao, Jiang Zehui, Zou Lin
Department of Orthopedics, The 960th Hospital of PLA, Jinan, China.
Medicine (Baltimore). 2025 Aug 29;104(35):e44226. doi: 10.1097/MD.0000000000044226.
Surgical treatment of osteochondral lesions of the talar dome (OLTD), for lesions larger than 15 mm2, surgical treatment remains challenging. To solve these problems, we presented a 3D-printed partial talar surface replacement (PTSR) technique for treating OLTD with severe lesions.
A 23-year-old male patient with OLTD experienced persistent pain for more than a year (Berndt and Harty classification V). Due to the pain, the patient was not allowed to walk long distances or engage in any physical activities.
Preoperative clinical examination and imaging (computed tomography and magnetic resonance imaging) confirmed the diagnosis of OLTD and Berndt and Harty classification V.
The patient underwent a 3D-printed PTSR surgical procedure.
Follow-up at 2 years after surgery showed good ankle function, with no pain or complications. The Visual Analog Scale score decreased from 5 to 1. The American Orthopedic Foot & Ankle Society scores improved from 65 to 90.
3D-printed PTSR is a new surgical method for OLTD with a larger damage area that can provide satisfactory outcomes. Definitive and convincing conclusions are difficult to draw owing to the limited number of cases in this study. Another limitation is the follow-up period, which was 2 years. In addition, medium- and long-term follow-up is required. For this patient, we planned an annual follow-up, which included physical evaluation and radiography. In the future, a prospective randomized controlled study should be conducted to manage the clinical surgical treatment of OLTDs, including metal partial replacements.
距骨穹窿骨软骨损伤（OLTD）的手术治疗中，对于面积大于15平方毫米的损伤，手术治疗仍具有挑战性。为解决这些问题，我们提出了一种3D打印距骨部分表面置换（PTSR）技术来治疗严重的OLTD损伤。
一名23岁的OLTD男性患者持续疼痛一年多（Berndt和Harty分类V型）。由于疼痛，患者无法长距离行走或参加任何体育活动。
术前临床检查及影像学检查（计算机断层扫描和磁共振成像）确诊为OLTD且为Berndt和Harty分类V型。
患者接受了3D打印PTSR手术。
术后2年随访显示踝关节功能良好，无疼痛或并发症。视觉模拟评分从5分降至1分。美国矫形足踝协会评分从65分提高到90分。
3D打印PTSR是一种用于损伤面积较大的OLTD的新手术方法，可提供满意的结果。由于本研究病例数量有限，难以得出确切和有说服力的结论。另一个局限性是随访期为2年。此外，还需要进行中长期随访。对于该患者，我们计划每年进行随访，包括体格检查和影像学检查。未来，应开展前瞻性随机对照研究来管理OLTD的临床手术治疗，包括金属部分置换。
