Retrospective Cohort Study Comparing Digitally Customized 3D-Printed Partial Talus Replacement and Ankle Arthrodesis for Extensive Talus Necrosis: Early Clinical Outcomes

Background:This retrospective study from a single center included 105 patients with avascular necrosis of the talus in our hospital from January 2021 to January 2024 and aimed to compare outcomes from management with customized 3-dimensional (3D) printed partial talus replacement with ankle arthrodesis. Material/Methods:The replacement group (n = 49) received digital customized 3D-printed partial talus replacement surgery, and the arthrodesis group (n = 53) underwent ankle arthrodesis.Efficacy of the 2 surgical methods was evaluated by comparing the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, pain visual analog scale (VAS), ankle range of motion (ROM), SF-36 quality of life scale, and complication rate before surgery and at last follow-up. Results:At final follow-up, the observation group showed significantly better outcomes than the conventional group in AOFAS score (85.88 ± 3.56 vs 78.51 ± 4.12, P < 0.001), ankle ROM (48.31° ± 4.95° vs 0.91° ± 1.13°, P < 0.001), and the SF-36 Physical Component Summary (74.12 ± 4.10 vs 55.83 ± 4.96, P < 0.001) and Mental Component Summary (81.26 ± 5.12 vs 68.15 ± 5.93, P < 0.001).VAS scores were also significantly lower in the observation group (1.71 ± 0.71 vs 2.57 ± 0.87, P < 0.001).Overall complication rates were similar (8.1% vs 11.3%, P = 0.592); however, the reoperation rate was lower in the observation group (0% vs 3.7%). Conclusions:In early follow-up, 3D-printed partial talus replacement for extensive talus necrosis demonstrates superior joint function, ROM, and quality of life compared with ankle arthrodesis, without increasing complications, suggesting it is a safe and effective joint-preserving alternative.