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.

This article focuses on the functional outcomes of 3D-printed total talus replacement (TTR) in two patients with avascular necrosis (AVN) of the talus who previously underwent failed revascularization using free vascularized medial femoral condyle (MFC) flaps. Both patients showed limited improvement in pain and ankle motion after TTR compared to a comparison group of 25 patients who underwent primary 3D-printed TTR without prior revascularization, with one patient ultimately requiring below-knee amputation. The study highlights that while vascularized bone grafting and 3D-printed TTR are established treatments for talar AVN, outcomes may be poorer when TTR is performed following failed revascularization. The authors note the small sample size and retrospective design as limitations and call for further research to clarify indications for revascularization versus total talus replacement.