Custom Patient-Specific 3D-Printed Titanium Truss Tibiotalocalcaneal Arthrodesis Implants for Failed Total Ankle Replacements: Classification, Technical Tips and Treatment Algorithm

Category: Ankle Arthritis; Ankle Introduction/Purpose: The management of failed total ankle replacements, with significant loss of bone stock, is challenging with high rates of complications and associated morbidity. Recent technological advances have enabled the development of patient-customized 3D-printed titanium truss arthrodesis implants which offer an alternative salvage option for failed total ankle replacements. Methods: A prospective observational study of six cases of failed total ankle replacements which were managed using custom patient-specific 3D-printed titanium truss arthrodesis implants. Technical tips, classification and a treatment algorithm were developed based on our initial experience. All p-values < 0.05 were considered significant. Results: Between November 2018 and March 2022, 6 patients underwent arthrodesis for failed total ankle replacements. Follow up was available for all cases. The mean follow up was 3.0 years (range 1-4.5). The mean MOXFQ Index improved from 73.1 to 32.3 (p< 0.05). The mean EQ-5D-5L Index improved from 0.366 to 0.743 (p< 0.05) and the EQ-VAS also improved from 53.0 to 63.3 (p=0.36). The mean VAS-Pain score at final follow up was 27.5. There were no cases of non-union. Conclusion: Custom patient-specific 3D-printed titanium truss arthrodesis implants are a viable alternative treatment option for failed total ankle replacements. MOXFQ Scores Following Custom Patient-Specific 3D-printed Titanium Truss Tibiotalocalcaneal Arthrodesis Implants for Failed Total Ankle Replacements