Custom constrained 3D total talus/navicular replacement

The utilization of 3D printing technology for combined total talus and navicular replacement with incorporation of subtalar joint fusion and total ankle replacement.

Talar avascular necrosis

Aseptic talar body collapse

Failure of total ankle arthroplasty with talar subsidence/collapse

Nonunion of talar fracture following open reduction and internal fixation (ORIF)

Failed nonoperative management

Detailed patient history must include history of trauma, arthritis, prior surgeries, and postoperative course.

Duration, degree of dysfunction, and intensity of pain should be documented.

Pain is predominately isolated to the ankle and hindfoot.

Range of motion (ROM) should be assessed. Typically, the patient’s ankle and subtalar joint ROM is severely limited due to pain and crepitus ( Fig. 9.1 ).

Clinical alignment is determined with the patient weight bearing. The surgeon should note any deformities including equinus and varus/valgus malpositioning.

The soft tissue envelope is examined for prior incisions, preulcerative lesions, global swelling, and signs of infection.

Examine the neurovascular status for signs of neuropathy or vascular impairment.