Custom-Made Total Talonavicular Replacement in a Professional Rock Climber

Sandro Giannini, Matteo Cadossi, Antonio Mazzotti, Laura Ramponi, Claudio Belvedere, Alberto Leardini

Research output: Contribution to journalArticle

Abstract

Professional athletes are often eager to resume sporting activities at preinjury levels. When facing the challenge of restoring joint function after a complex articular fracture, innovative solutions must be explored. We describe the results of what we believe to be the first custom-made talonavicular prosthesis implanted in a professional rock climber who had developed post-traumatic ankle and talonavicular arthritis as sequelae of a complex talar and navicular fracture. Using computed tomography scan reconstruction of the contralateral healthy ankle and direct metal laser sintering, a custom-made talonavicular prosthesis was obtained and implanted using an anteromedial approach. The patient was clinically and radiographically evaluated every 6 months after surgery for 30months. A 3-dimensional videofluoroscopic analysis was performed to assess the range of motion about the prosthesis. At the last follow-up visit, the functional scores were excellent (Tegner activity scale score of 9 of 10), and he had completely resumed his sporting activity. The American Orthopaedic Foot and Ankle Society score had increased from 36 to 81 points, and no signs of radiolucency were observed on the radiographs. The 3-dimensional videofluoroscopic analysis showed 15° of dorsiflexion and 4° of plantar flexion at the ankle. A customized solution is an option when the patient's expectations are not likely to be met by standard treatment, such as arthrodesis. A custom-made talonavicular prosthesis can be an effective solution for complex ankle injury sequelae in patients demanding high functionality.

Original languageEnglish
JournalJournal of Foot and Ankle Surgery
DOIs
Publication statusAccepted/In press - 2015

Fingerprint

Ankle
Prostheses and Implants
Joints
Ankle Injuries
Arthrodesis
Articular Range of Motion
Athletes
Arthritis
Orthopedics
Foot
Lasers
Metals
Tomography
Lysholm Knee Score
Therapeutics

Keywords

  • Custom prosthesis
  • Gait study
  • Osteonecrosis
  • Sports
  • Trauma

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Custom-Made Total Talonavicular Replacement in a Professional Rock Climber. / Giannini, Sandro; Cadossi, Matteo; Mazzotti, Antonio; Ramponi, Laura; Belvedere, Claudio; Leardini, Alberto.

In: Journal of Foot and Ankle Surgery, 2015.

Research output: Contribution to journalArticle

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