Talar Body Synthesis Essay

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Advanced ankle arthritis, avascular osteonecrosis (AVN), and osteomyelitis (OM) of the ankle remain a surgical challenge in the foot and ankle arena with limited treatment options (64,62,61,52,42). The role of the talus within the ankle joint is of particular interest as it guides sagittal motion of the lower extremity (22). Multiple medical comorbidities including but not limited to autoimmune disease, trauma, avascular necrosis (42,52-54), or other idiopathic etiologies contribute to total loss of the talus (40, 43, 61-64). Furthermore, collapse of the talar body as a complication of total ankle arthroplasty (51), talectomy in infection and septic talus necrosis (60) or severe bone defects due to tumor resection (59) may result in the need …show more content…
Harnroongroj et al (8) was the first to document outcomes of 16 patients treated by first-generation talar body prosthesis in 1997. Eight out of nine patients, who were evaluated 11 to 15 years postoperatively, had a satisfactory result. In 2014, Harnroongroj (9) published outcomes in a study with the longest follow-up period of 10-36 years, 28 of the 33 talar body prosthesis were still in place and 5 had failed prior to 5 years. In 1999, Tanaka et al designed talar body prosthesis to preserve ankle motion in patients with aseptic necrosis (43,70), followed by several subsequent prosthesis design revisions to improve outcomes after prosthesis implantation (9). Taniguchi et al (45) explored two types of talar body prosthesis.The first-generation used a peg for the neck of the talus and second-generation removed the peg. Despite acceptable results in eight of 14 patients treated with the latter implant, the author recommended TTR after a mean follow-up period of 98 months. In 2005, Taniguchi et al (46) reported excellent primary outcomes of postoperative function and pain in 55 patients with osteonecrosis of the talus treated with prosthetic TTR.

Talar body and TTR use further expanded to young and more active patients (when). In 2004, Magnan et al (44) first reported use of talar body prosthesis combined with standard S.T.A.R. total ankle arthroplasty system in a professional 45-year-old male skier and rock-climber that sustained open talar dislocation and medial malleolar fracture. Stevens et al (58) first reported TTR after traumatic open talar extrusion in a 14-year-old patient in 2007. Other investigators incorporated and modified TAR to address talar

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