BALTIMORE —Foot and ankle surgeons at MedStar Union Memorial Hospital are making use of novel 3D printing technology to custom replicate the talus bone in patients suffering from bone death known as avascular necrosis (AVN). Reconstruction of the ankle with a 3D printed replacement ensures a perfect match of the patient’s anatomy and averts the need for motion-limiting fusion surgery or amputation.
In December, orthopaedic surgeon Dr. Walter Hembree became the first specialist within MedStar Health to perform a total talus replacement with a 3D printed implant when he reconstructed the ankle of Kamonte Johnson, a 20-year-old musician and college student, whose talus was fragmenting and collapsing from AVN.
The talus bone is critical to the function of the ankle: it bears the weight of the entire body, and joins the two leg bones, the tibia and fibula, to the foot. Fractures of the talus are a common cause of AVN, which occurs when the bone dies from a lack of blood supply. However, the condition can also occur without any known cause.
The implant fabrication process begins by reversing CT images of the healthy talus bone in the patient’s opposite foot to create three implants of slightly different sizes. In this case, Dr. Hembree utilized Restor3D, a company in Durham, North Carolina, to replicate Kamonte’s diseased bone. During surgery, the best fit is determined, and the final cobalt chrome talus is implanted.
“Three-dimensional printing technology is becoming more prevalent but is still very young,” said Dr. Hembree. “This approach is a huge leap into the future of foot and ankle surgery. The patient had complete talar avascular necrosis. Without this technology, the options for this patient were limited and likely would have involved fusing his heel bone to his leg bone. After discussing options, we decided together that replacing the bone with a 3D printed implant would be a good option for him, and I was very pleased that we could offer it. The results have been exciting."
“I’m very active,’ said Kamonte. “I thought my pain was an overuse injury, but I went from walking ten blocks with the marching band, to not being able to walk at all. I couldn’t even put my shoe on, the pain got so bad. In my first physical therapy session, I was surprised at how much motion I already had in my foot. I am walking again without pain for the first time in years.”
To make an appointment with Dr. Hembree, or any of the experts at MedStar Orthopaedic Institute, call 877-34-ORTHO.
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