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September 12, 2026Foot & Ankle InternationalOpen Access

Motion-Preserving Salvage for Failed Total Ankle Arthroplasty or Talar AVN: Outcomes of Combined Total Ankle Arthroplasty with Custom 3D-Printed Total Talus Replacement

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Authors

RSRachit SaggarRSRichard M. SmithEHEva Heidinger

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Overview

Retrospective case series reveals viable joint mobility and rapid recovery after 3D-printed talus replacement in severe ankle pathology, highlighting motion-preserving salvage feasibility.

Key Points

  • To evaluate the clinical, radiographic, and functional outcomes of combining total ankle arthroplasty with custom 3D-printed total talus replacement as a motion-preserving salvage technique.
  • Retrospectively reviewed 18 consecutive patients (10 females, 8 males; mean age 57.8 ± 10.8 years) treated between September 2020 and December 2023 with a mean follow-up of 36.8 ± 16.6 months.
  • Indications included talar component collapse after total ankle arthroplasty (n=9) and talar avascular necrosis with concurrent arthritis (n=9), all managed with 3D-printed total talus replacement, subtalar fusion using two screws, and bone marrow aspirate concentrate.
  • The overall complication rate was 33.3% (95% CI: 15.2%-57.3%), occurring in 44% of avascular necrosis cases and 22% of revision arthroplasty cases, with a reoperation rate of 11.1% (95% CI: 3.1%-32.8%) including one below-knee amputation.
  • Patients transitioned to a controlled ankle motion boot at a mean of 19.9 days, achieved full weight-bearing at a mean of 46.9 days, returned to regular footwear at a mean of 10.7 weeks, and all demonstrated 100% radiographic osseointegration to the calcaneus.

Cite This Study

Saggar et al. (2026) studied this question.

synapsesocial.com/papers/6aa51ee4327956e4761f8d30https://doi.org/10.1177/10711007261471856
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