3D-printed Talar Components for the Reconstruction of Large Osteochondral Lesions of the Talus

Abstract

Category: Ankle Introduction/Purpose: The reconstruction of large osteochondral lesions of the talus (OLTs) presents a clinical challenge. In this study, a biomechanical experiment was performed using 3D-printed talar components for the reconstruction of large talar lesions, and intra-articular stress tests were conducted before and after implantation. Methods: Eight cadaveric ankle specimens were used in this study. After the specimen was fixed on an Instron mechanical testing machine, a piece of Fuji pressure-sensitive film was inserted into the articular cavity. A vertical pressure of 1500-N was applied to the ankle when it was in different positions, i.e. neutral, 10 degrees of dorsiflexion, and 14 degrees of plantar flexion. The total pressure-bearing area and the pressure intensity (MPa) on the talus were calculated to determine their changes before and after implantation. Results: The pressure-bearing area of the talus varied with the ankle position in the following order: 10 degrees of dorsiflexion > neutral position > 14 degrees of plantar flexion (P<0.05). The pressure intensity exerted on the talus varied in ascending order: 10 degrees of dorsiflexion < neutral position < 14 degrees of plantar flexion (P<0.05). However, the intensity of the pressure on the graft was insignificantly different from the overall pressure intensity on the talus (P>0.05). Conclusion: Treatment using a 3D-printed talar component can achieve precise reconstruction of a large OLT after the surgical removal of the talar lesion. The pressure intensity on the repaired site did not change before and after the operation, indicating the clinical feasibility of this approach.