3D-printed navicular replacement for giant cell tumor: a case report on a feasible indication and surgical outcome

Introduction and importance: Giant cell tumor of the navicular is extremely rare and difficult to manage due to the complex biomechanics of the midfoot. Conventional curettage carries a high recurrence risk. This report presents a feasible approach using total navicular replacement for a giant cell tumor, offering a solution for achieving both oncologic control and functional reconstruction. Case presentation: A 32-year-old man presented with progressive midfoot pain and a Campanacci grade II giant cell tumor confined to the navicular. Imaging showed near-complete osteolysis with an intact cortex. A patient-specific titanium implant was designed using virtual surgical planning, incorporating porous surfaces and fixed screw trajectories for talocuneiform fusion. En bloc excision of the navicular and implantation of the custom device were performed through a medial approach. Postoperative recovery was uneventful. By 2 years, the patient was pain-free, exhibited a normal gait, and achieved excellent functional scores, with imaging confirming osseointegration and no recurrence. Clinical discussion: While three-dimension (3D print implants are increasingly used in complex foot and ankle reconstructions, their application for primary bone tumors in the midfoot has not been previously reported. This case demonstrates that custom implants can provide stable midfoot restoration when conventional grafting or curettage is insufficient. Advantages include precise anatomical matching and reliable fixation; however, cost and long-term durability remain considerations. Conclusion: Total navicular replacement using a custom 3D-printed implant achieved excellent 2-year oncologic and functional outcomes in this rare giant cell tumor case. This technique represents a viable and innovative reconstructive option for select midfoot tumors.