Designing and additive manufacturing of talus implant for post-traumatic talus avascular necrosis: a case study.

New technologies in additive manufacturing and patient-specific CT-based custom implant designs make it possible for previously unimaginable salvage and limb-sparing operations a practical reality. This study presents the design and fabrication of a lattice-structured implant for talus replacement surgery. Our primary case involved a young adult patient who had sustained severe damage to the talus, resulting in avascular necrosis and subsequent bone collapse. This condition caused persistent and debilitating pain, leading the medical team to consider amputation of the left foot at the ankle level as a last resort. Instead, we proposed a Ti6Al4V-based patient-specific implant with lattice structure specifically designed for pan-talar fusion. Finite element simulation is conducted to estimate its performance. To ensure its mechanical integrity, uniaxial compression experiments were conducted. The implant was produced using selective laser melting technology, which allowed for precise and accurate construction of the unique lattice structure. The patient underwent regular monitoring for a period of 24 months. At 2-years follow-up the patient successfully returned to activities without complication. The patient's functional status was improved, limb shortening was minimized.

Multicenter outcomes of arthroscopic surgery for femoroacetabular impingement in the community hospital setting.

The purpose of this study is to determine multi-center outcomes from arthroscopic surgery for femoroacetabular impingement in the community hospital setting. A prospective design with 2-year minimum follow-up using the nonarthritic hip score (NAHS), a 100-point scale of perceived post-operative change for pain, activities of daily living, sports activities, and patient satisfaction was implemented at three community hospitals. Of 150 enrolled patients (159 hips) with mean age of 40 years (range, 12-73), there was 81% participation. Mean NAHS at preoperative was 54.9, 3 months: 66.6, 12 months: 74.9 and 24 months: 75.4. This represents a 20.5-point improvement in NAHS (P < 0.001). On the 100-point scale, pain was rated +73.5, ADL's: +76.2 and sports: +68.6. 64% of patients were satisfied with their surgical outcome. Conversion arthroplasty rate was 8.8% and complication rate was 2.5%. In conclusion, arthroscopic surgery for symptomatic femoroacetabular impingement in the community setting provides safe and successful outcomes.