Samuel B. Adams Jr.
Use of patient-specific 3D-printed titanium implants may provide successful treatment of a variety of bone defects and deformities in difficult to treat foot and ankle and lower extremity pathologies, according to published results.
Samuel B. Adams Jr., MD, of Duke University Medical Center, and colleagues performed an arthrodesis of the tibia to the hindfoot using a custom 3D-printed titanium cage (4WEB Medical) and an intramedullary rod on a 46-year-old female patient with a distal tibia fracture with substantial distal-third tibia bone loss. Researchers collected plain radiographs approximately every 6 to 12 weeks and CT scans every 6 months, as well as the foot and ankle ability measure and American Orthopaedic Foot and Ankle Society ankle-hindfoot score preoperatively and at recent follow-up of 60 months after surgery.
Results showed successful bone incorporation of the talus, calcaneus and tibia on plain radiograph and CT scan. Researchers found the patient had a foot and ankle ability measure activities of daily living subscale score of 79 and a sports subscale score of 46. Functionality during both activities of daily living and sports-related activities were rated as 85% of what it was prior to injury, according to results. Researchers noted the patient had an AOFAS ankle-hindfoot scale score of 71, mainly due to the loss of sagittal and hindfoot motion, and the patient reported mild, occasional pain.
“Until the introduction of 3D printing into medicine, there were no reliable treatment options for large bone defects. This case report demonstrates that custom, 3D printed implants can be used to successfully treat these defects with longevity,” Adams told Healio Orthopedics. “However, research is still needed to improve bone ingrowth, prevent infection and optimize strength in these custom implants.” – by Casey Tingle
Disclosure: Adams reports no relevant financial disclosures.