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What is Custom 3D Printed Ankle Replacement?

In a custom 3D printed ankle replacement surgery, the damaged or worn ankle joint is replaced with a patient-specific implant that is usually made of cobalt-chromium-molybdenum powder. Prior to surgery, a CT scan of your foot and ankle is obtained. Based on the scan results, 3D bone models of the ankle bones which include the tibia, fibula, talus, and calcaneus are generated. Using the 3D bone models, a patient-specific ankle implant is developed that matches your specific foot and ankle anatomy. 

A custom 3D printed ankle implant restores the natural ankle joint and provides ease of movement. It offers better precision and is more suited to individual needs.

Indications for Custom 3D Printed Ankle Replacement

Your surgeon may recommend a custom 3D printed ankle replacement:

  • If you have advanced osteoarthritis of the ankle that has not responded to non-surgical treatments
  • Need revision for a failed implant
  • Presence of a tumor in the ankle joint

Contraindications for Custom 3D Printed Ankle Replacement 

Custom 3D printed ankle replacement is contraindicated for:

  • Acute or chronic infections
  • Osteomyelitis and severe osteoporosis
  • Charcot foot
  • Severe osteonecrosis of the talus

Pre-surgical care for Custom 3D Printed Ankle Replacement

Before scheduling the ankle replacement surgery, your orthopedic surgeon examines your foot and ankle. You will be given specific instructions to follow until the date of your surgery. You may have restrictions regarding your food intake, work schedule, and exercise prior to the surgery. 

Custom 3D Printed Ankle Replacement Procedure

Custom 3D printed ankle replacement is performed under general anesthesia.

  • Your surgeon makes an incision over the front of your ankle. 
  • The muscles are retracted, and tendons and ligaments are moved away to expose the ankle joint.
  • Then, the damaged regions of the tibia, fibula, and talus are removed using surgical jigs and guides.
  • The remaining healthy bones are reshaped to fit the custom implant. 
  • The 3D printed custom implant is placed in the ankle joint.
  • The custom implant is placed in proper position using bone cement and instrumentation such as screws to provide stability and support. 
  • Your surgeon will assess the range of motion of the new implant.
  • At the end of the surgery, tendons and other soft tissue structures are positioned back to cover the new joint. 
  • The wound is sutured and covered with a sterile dressing.

Post-surgical Care for Custom 3D Printed Ankle Replacement

You may be required to stay in the hospital for 2-3 days after your ankle replacement surgery.  

  • The treated ankle will be immobilized with the help of splints and a custom dressing. 
  • Avoid bearing weight on the ankle for around 6 weeks and use crutches for walking. 
  • You will be prescribed medications to prevent blood clots.
  • Swelling and discomfort can be managed with prescription pain medicines, applying ice packs, and by elevating your ankle above the heart level while resting. 
  • Usually, a drain tube is inserted into the joint during surgery to drain blood from the incision, which is removed within 1-2 days after the surgery. 
  • Sutures are removed after 10-15 days. You should take care that the incision is kept clean and dry.
  • You will be referred to a physical therapist soon after your surgery to regain range of motion of the new ankle. 

You should go for follow-up examination after about six weeks. 

Benefits and Advantages of Custom 3D Printed Ankle Replacement

Custom 3D printed ankle replacement offers the following benefits:

  • Personalized prostheses/subject-specific customization
  • Provides a consistent motion pattern
  • Restores mobility and stability like a natural ankle joint
  • Reduces and eliminates ankle pain and stiffness

Risk and Complications of Custom 3D Printed Ankle Replacement

Every surgical procedure carries some amount of risk. Similarly, custom 3D printed ankle replacement may also have certain risks and complications. These may include:

  • Fracture of the tibia or fibula
  • Dislocation of the ankle
  • Damage to nerves or blood vessels
  • Blood clots (DVT or deep venous thrombosis)
  • Infection
  • Loosening of artificial components
  • Instability