A Novel Indication for 3D-Printed Titanium Total Talus Replacements in Isolated Talar Tumors.

Abstract

Background: Intraosseous talar tumors are rare and usually require complex surgery such as tibiocalcaneal fusion with allograft, resulting in a poor functional outcome. Total talus replacement (TTR) has been primarily described predominantly after trauma for talar avascular necrosis in the absence of peri-talar arthrosis. We present our small initial case series of this novel indication for a TTR to treat a localized talus tumor with no associated osteoarthritis.

Methods: Four patients underwent total talus replacement with a custom-made 3D-printed talar implant for an isolated intraosseous talar tumor between February 2021 and December 2022. The pathologies were fibrous dysplasia, a primary vascular tumor, and 2 cases each with an isolated metastatic endometrial carcinoma. All 4 cases were performed by the same surgical team. The Manchester-Oxford Foot Questionnaire (MOXFQ) and EuroQoL-5 Dimensions (EQ-5D) questionnaire were recorded pre- and postoperatively.

Results: At a mean follow-up of 26 months (range, 14-37) all our patients showed an improvement in their MOXFQ and EQ-5D scores. Average MOXFQ scores decreased from 57.3 to 20.3. Three of the 4 patients showed an improvement in their function and ability to perform usual activities. One patient scored an improvement in their mobility. None had any intraoperative or postoperative complications.

Conclusion: TTR is an alternative technique for the management of isolated talar tumors, which will maintain movement and provide better function than previous options.