Abstract:

Objective  To evaluate its surgical effect and surgical safety of customized 3D printing cobalt-chromy-molybdenum partial talus for large uncontained osteochondral lesions of talus(OLT). Methods  From October 2021 to April 2023, patients with large uncontained talus osteochondral lesions underwent 3D customized partial talus replacement in our center were enrolled.  The 3D modeling software helped to design customized plan and prostheses prototype. Regular follow-up visits were conducted at 3 month, 6 months and 1 year after surgery. Ankle function and pain were assessed again, and postoperative X-rays, implant position, and presence of periprosthetic radiolucency lines were assessed. Results  The average lesion surface area of 12 patients was (252.5±91.1) mm² and the volume was (1 571.5±99.0) mm³. The mean follow-up time was (21.7±5.6) months. The overall satisfaction rate is 91.7%. American Orthopedic Foot and Ankle Society（AOFAS) score (hindfoot) increased from (69.42±10.36)to(89.83±6.89).Foot Function Index(FFI） score decreased from (55.00±31.86)to（14.08±7.95）. The average pain Visual Analog Scale(VAS) score decreased from （3.75±2.14)to(1.17±1.19), with statistically significant differences. There were no major complications such as infection, poor wound healing, and non-union of fractures. Conclusion  For large uncontained OLT, the 3D customized printing prosthesis treatment showed high satisfaction with surgical results, improved significantly the patient function, and relieve the pain. No major complications were observed during an average follow-up of 21 months. It provides a novel clinical solution for the treatment of such OLTs.

Key words: osteochondral lesion of talus, customized 3D printing, partial talus replacement