Avascular Necrosis and Total Talus Replacement
Talus avascular necrosis (AVN) from many different etiologies result in bone pain, bone collapse, and hindfoot deformity. Early AVN can be treated with nonsurgical means. However, patients often present with mid- to late-stage disease requiring surgical intervention to maintain a plantigrade foot. Traditional operative procedures include isolated tibiotalar or subtalar arthrodeses, or if both the ankle and subtalar joints are arthritic, a tibiotalocalcaneal arthrodesis. Three-dimensional printing has provided our community with a new treatment option and has provided the patient with the ability to maintain motion. However, this technology is new and we must proceed with caution. The patient needs to understand the limitations of three-dimensional printing as it interfaces with host tissues. The surgeon must understand the design considerations of a custom implant, nuances of implantation, and potential complications..
