{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:00:03Z","timestamp":1780556403547,"version":"3.54.1"},"reference-count":10,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"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:p>Critical sized bone defects in the ankle are becoming increasingly more common in patients undergoing limb reconstruction with tibiotalocalcaneal arthrodesis. Bulk allografts have not fared well over time. There have been scattered preliminary reports using custom spinal cages or 3D-printed Titanium Implants to address the critical bony defect; however, the cost of these devices is prohibitive in many clinical practice settings. The purpose of this investigation is to report the preliminary experience using a commercially available Trabecular Metal (Zimmer-Biomet) tibial metaphyseal cone combined with a retrograde locked intramedullary nail to address this challenging problem. Eight consecutive patients underwent tibiotalocalcaneal arthrodesis using a commercially available Trabecular Metal tibial metaphyseal cone combined with a retrograde locked intramedullary nail. Five developed bone loss secondary to neuropathic (Charcot) bony resorption and 3 underwent surgery for failed total ankle arthroplasty. All 8 patients eventually achieved clinical and radiographic healing and were able to ambulate with standard footwear. One patient developed a postoperative wound infection at the site of calcaneal locking screws, which resolved with debridement and parenteral antibiotic therapy. Critical bone defects about the ankle have successfully addressed with custom 3D titanium implants. This small series suggests that similar clinical outcomes can be achieved with the use of a commercially available porous tantalum metaphyseal spacer borrowed from our arthroplasty colleagues, combined with the use of a retrograde locked intramedullary nail.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Levels of Evidence<\/jats:bold>\n                    : Level 4: Retrospective case series\n                  <\/jats:p>","DOI":"10.1177\/19386400241236664","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T05:16:55Z","timestamp":1710825415000},"page":"429-431","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Preliminary Experience With Commercially Available Trabecular Metal Tibial Cones Combined With a Retrograde Locked Intramedullary Nail for Bony Defects in Tibiotalocalcaneal Arthrodesis"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4856-9792","authenticated-orcid":false,"given":"Michael S.","family":"Pinzur","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery &amp; Rehabilitation, Loyola University Health System and Loyola University Medical School, Maywood, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam P.","family":"Schiff","sequence":"additional","affiliation":[{"name":"Loyola University Health System and Loyola University Medical School, Maywood, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamran","family":"Hamid","sequence":"additional","affiliation":[{"name":"Loyola University Health System and Loyola University Medical School, Maywood, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"LeDuc","sequence":"additional","affiliation":[{"name":"Loyola University Health System and Loyola University Medical School, Maywood, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001115"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-020-03525-0"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.18.00842"},{"key":"e_1_3_2_5_2","first-page":"12","article-title":"Reconstruction of extremely long bone defects with vascularized fibula bone grafts","volume":"6","author":"Wee C","year":"2019","unstructured":"Wee C, Ruter D, Shulz S, et al Reconstruction of extremely long bone defects with vascularized fibula bone grafts. Plast Aesthet Res. 2019;6:12.","journal-title":"Plast Aesthet Res"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1081406"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001420"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713488765"},{"key":"e_1_3_2_9_2","volume-title":"Presented at the American Orthopaedic Foot and Ankle Society 21st Annual Summer Meeting","author":"LaRue B","unstructured":"LaRue B, Anctil E. Use of a titanium lumbar fusion cage as a structural support in reconstructive foot and ankle surgery. Presented at the American Orthopaedic Foot and Ankle Society 21st Annual Summer Meeting; July 14-17, 2005. Boston, MA."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2014.12.010"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/10711007221077113"}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400241236664","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19386400241236664","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19386400241236664","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:32:18Z","timestamp":1777411938000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19386400241236664"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,19]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1177\/19386400241236664"],"URL":"https:\/\/doi.org\/10.1177\/19386400241236664","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,19]]}}}