Custom-made implants in ankle bone loss: From total ankle replacement to reconstruction-arthrodesis

INTRODUCTION: In recent years the management and treatment of severe bone loss and severe deformities has improved, thanks to the advancement of available technologies. 3D printing represents the process of creating a predefined object through the precise deposition of material layer upon layer, allowing implants to be customized according to the anatomy of each patient. This work is set as a narrative review of the most recent reconstruction techniques for severe ankle deformities because of traumas, avascular necrosis, fail of former ankle prosthetic implant. EVIDENCEACQUISITION: Asystematic research based on PubMed and Google Scholar databases has been performed, covering the period between 1989 and 2021. Two reviewers independently screened titles and abstracts from all identified studies to assess their eligibility to the research question. EVIDENCESYNTHESIS: The process steps leading to the implantation of a custom-made prosthesis or to the execution of a custom-made arthrodesis can consist of several phases: Medical imaging collection and processing, modelling, and designing, surgical intervention. CONCLUSIONS: The use of 3D-printed patient-specific devices allowed the execution of surgical procedures that, for anatomical reasons, would have been impossible to perform with standard implants. It still remains to be clarified, between total ankle replacement and reconstruction/arthrodesis, which allows the best long-term function.