{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:09:03Z","timestamp":1777615743076,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Avascular necrosis (AVN) of the talus is 1 of the most difficult foot and ankle pathologies to diagnose and manage. The purpose of this study was to report on the functional outcomes of 3D-printed total talus replacement (TTR) in 2 patients with talar AVN who both underwent a failed revascularization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a case series of 2 patients with TTR after a failed revascularization and a comparison group of 25 patients with primary TTR. Clinical and functional outcomes are used to compare both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patient 1 had a postrevascularization Visual Analogue Scale (VAS) pain score of 9. Imaging showed failure of the medial femoral condyle to incorporate with talar fragmentation. Patient underwent TTR at 5 months postoperatively. At 2 years postoperatively, the patient underwent a cavovarus foot reconstruction; however, patient continued to suffer from ankle pain (VAS 6) and ultimately underwent below knee amputation at 3 years after the TTR. Patient 2 initially underwent a core decompression for a talar bone infarct followed by revascularization procedure at 6 months postoperatively due to persistent pain and bony infarcts. At 18 months postrevascularization, the patient had a VAS pain score of 9 and progression of the AVN. She underwent a TTR. At 1-year follow-up, the VAS pain score was 8. Both patients had an ankle plantarflexion of 30\u00b0 at their last TTR follow-up. The comparison group consisted of 25 patients who underwent 3D-printed TTR with mean postoperative VAS score and ankle plantarflexion of 3.7\u00b0 and 41.8\u00b0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients 1 and 2 demonstrated reduced plantarflexion and ankle motion after TTR relative to the comparison group which improved in both physical assessments. The first patient needed a below knee amputation for persistent pain. Patient 2 showed less improvement in all the foot and ankle outcome scores as compared with the primary TTR group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level V: Retrospective case series<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19386400221138640","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:45:05Z","timestamp":1670546705000},"page":"341-351","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["3D-Printed Total Talus Replacement After Free Vascularized Medial Femoral Condyle Osteocutaneous Flap for Avascular Necrosis of the Talus Leads to Poor Clinical Outcomes: A Case Series"],"prefix":"10.1177","volume":"18","author":[{"given":"Naji S.","family":"Madi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-4030","authenticated-orcid":false,"given":"Aman","family":"Chopra","sequence":"additional","affiliation":[{"name":"School of Medicine, Georgetown University, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda N.","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhail","family":"Mithani","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selene G.","family":"Parekh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.15.00087"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-18-00225"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.01680"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2004.02.010"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.00888"},{"key":"e_1_3_2_7_2","first-page":"3135","article-title":"Effect of liquid-electric extracorporeal shock wave on treating traumatic avascular necrosis of talus","volume":"14","author":"Zhai L","year":"2010","unstructured":"Zhai L, Sun N, Zhang BQ, Wang JG, Xing GY. 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