PMC7268162_01
(a) AP and (b) lateral view showing lateral signs of AVN. (c) Varus hindfoot.
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AVN Irwin grade I (Chart 1): segmental articular deficit isolated to either a talar portion; subtype B: AVN deep to the articular segment (Figures 1 and 2). A percutaneous bone biopsy was made in order to confirm the AVN diagnosis (Figure 3).
(a) Osteonecrosis of the talus on a T2-weighted sagittal MRI slice and (b) 50% of lateral talus was compromised.
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AVN Irwin grade I (Chart 1): segmental articular deficit isolated to either a talar portion; subtype B: AVN deep to the articular segment (Figures 1 and 2). A percutaneous bone biopsy was made in order to confirm the AVN diagnosis (Figure 3).
(a) AP and (b) lateral view. Radioscopic-guided bone biopsy.
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AVN Irwin grade I (Chart 1): segmental articular deficit isolated to either a talar portion; subtype B: AVN deep to the articular segment (Figures 1 and 2). A percutaneous bone biopsy was made in order to confirm the AVN diagnosis (Figure 3).
(a) Patient-specific cutting guide, (b) medial view of the implant showing internal structure, (c) posterior view of the implant showing medial pegs and screws and (d) final position implant.
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The information was saved into a software (Mimics 11; Materialize , Belgium) that allowed for 3D handling of the bones and articulations (Figure 4).
Macroscopic signs of hemi talar AVN.
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When lateral portion of the talus was resected, it showed macroscopic signs of AVN (Figure 5).
(a) Lateral and (b) medial view of the implant showing mirror-polished articular surface and combined solid-lattice internal structure.
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The Ti6Al4V prosthesis was implanted with a matching less than 1 mm (Figures 6 and 7) and subtalar arthrodesis (evident subtalar chondral lesion was seen under direct vision) was added to correct varus hindfoot.
(a-d) Tibial oblique plafondplasty, resection of hemilateral talus, test prosthesis placement.
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The Ti6Al4V prosthesis was implanted with a matching less than 1 mm (Figures 6 and 7) and subtalar arthrodesis (evident subtalar chondral lesion was seen under direct vision) was added to correct varus hindfoot.
(a) AP and (b) lateral view showing the patient-specific 3D-printed hemi talar prostheses. (c) Axial CT scan osteointegration.
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X-rays and CT scan showed successful bone integration (Figure 8).