Introduction: Total ankle arthroplasty (TAA) is a recognized alternative to arthrodesis for end-stage ankle arthritis.However, failed TAA complicated by severe talar subsidence and bone loss often renders revision arthroplasty not feasible.Conventional salvage arthrodesis techniques using structural grafts or metal blocks are associated with heterogeneous outcomes and high complication rates.In recent years, patient-specific three-dimensional (3D) printed implants have emerged as a promising option for addressing large bone defects.Case Presentation: A 48-year-old female presented with failed TAA complicated by advanced talar collapse and bone loss.She underwent tibiotalar arthrodesis using a patientspecific 3D-printed porous titanium talus implant with an intramedullary canal designed to accommodate retrograde nail fixation.This design provided immediate structural stability and simplified the procedure by eliminating the need for intraoperative canal preparation.At the 11-month follow-up, radiographs demonstrated progressive osteointegration, and the patient reported significant pain reduction and functional improvement, with no complications observed.Discussion: Compared with conventional salvage methods, patient-specific 3D-printed implants offer optimal anatomical conformity, reliable structural stability, and the potential to promote osteointegration.This case highlights the practical benefits of an implant intentionally designed to facilitate intramedullary fixation in the setting of severe talar collapse after failed TAA. Conclusion:Patient-specific 3D-printed porous talus implants with intramedullary canal design may represent a valuable salvage option for failed TAA with severe talar collapse.Despite promising early results, larger cohorts and long-term follow-up are needed to validate this approach.This report adds to the growing body of evidence supporting custom 3Dprinted implants for complex ankle salvage.
Erginoğlu et al. (Wed,) studied this question.