May 4, 2016 | By Benedict
Dr. Mark Myerson, a surgeon at the Mercy Medical Center in Baltimore, Maryland, is pioneering a “life-changing” new kind of ankle surgery, using 3D printing to create cobalt and chrome talus replacements. Patients undergoing the procedure have regained up to 75% normal ankle function.
A reckless use of metaphor it may be, but one could easily consider the talus, the second largest of the foot’s tarsal bones, as the Achilles heel of the ankle. The bone is an unusual but vital part of the human skeleton: no muscles are attached to it, but it enables the foot to move in all directions. The talus is, however, particularly vulnerable to impact injuries, due to its limited blood circulation. Falls and collisions can cause the bone to fracture, and many of these injuries can lead to avascular necrosis (AVN), the death of the bone. As horrifying as that may sound, respected orthopedic surgeon Dr. Mark Myerson is pioneering a first-of-its-kind solution to the problem, using 3D printing to create patient-specific talus replacements.
With 3D printing now used in all sorts of medical procedures, Myerson was quick to spot the technology’s potential to assist his patients, many of whom are suffering from AVN of the talus. When patients begin to develop AVN after receiving trauma to the ankle, the subsequent deterioration of the talus can be slow and painful. “Over time the bone will crumble and collapse, like a squashed orange,” Myerson explained. “You’re left with a flattened, painful and arthritic ankle.”
Usually, these patients have very few options available to them, the best being a fusion of the heel and leg. Although this can offer an improvement to some patients, surgeons such as Myerson are extremely skeptical of the procedure, as it causes the patient to lose all movement in the affected ankle. Fortunately, 3D printing is enabling surgeons to treat AVN in a more effective manner, with physiologically accurate 3D printed talus prostheses posing no such threat to the flexibility of the ankle.
The first-of-its-kind procedure, pioneered by Myerson and his team at the Mercy Medical Center in Baltimore, involves imaging the patient’s unaffected, healthy ankle with a CAT scan, before flipping the image to resemble a healthy version of the other, AVN-affected ankle. 3D modeling software is used to generate a 3D model of a new, healthy talus, which is then 3D printed in cobalt and chrome with machinery provided by 4Web Medical. Several plastic prototypes are tested to determine the correct size for the patient, after which the metal talus is implanted.
The results of the 3D printed talus prostheses have been spectacular, with patients regaining up to 75% normal ankle function with the metal implant in place. Myerson believes that this new technique provides a far better patient experience than fusion of the heel and leg. “If you have a fusion, there is no movement,” Myerson said. “The talus replacement allows for the movement of both the ankle and subtalar joints which make moving the foot up and down and side to side possible.”
Myserson is hugely optimistic that the new technique could help patients to recover from talus injuries better than ever before: “I’ve been practicing orthopedic surgery of the foot and ankle for 32 years and it is rare that something like this comes along that help patients in this way,” Myerson said.
Posted in 3D Printing Application
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