What Is A Total Talus Replacement?
Total talus replacement is a surgical procedure performed for avascular necrosis of the talus. Avascular necrosis of the talus means that the talus bone (the bone in the center of the ankle) has lost its blood supply and is no longer alive. This may
happen after a bad injury to the talus or for other reasons, including steroid use and alcohol abuse. Avascular necrosis of the talus is often painful and can lead to other problems, including arthritis and stiffness of the joints around the talus.
Total talus replacement is only performed for severe avascular necrosis that involves most of the talus bone. It involves replacing the talus bone with a metal bone custom-designed for you.
Most patients stay overnight one night in the hospital after surgery. Usually the first 2 weeks after surgery are spent in a splint or cast, followed by 4-6 weeks in a walking boot. You may be allowed to put weight on your foot after 2 weeks, but it may
be longer depending on any additional procedures you might have needed.
Risks and Complications
Because total talus replacement is a new procedure, it is not known yet how patients do over the long-term. Most patients have better function and less pain after the surgery, but we do not know how long the implants last.
If the total talus replacement fails, you may need to have a fusion procedure, in which multiple bones in your foot and ankle are joined together, or potentially an amputation (loss of your leg)
Short-term risks of the surgery include nerve injury, which usually leads to some numbness and tingling over the top of the foot. In most cases, this improves over time. Infection is a serious risk; if it is a deep infection, the whole talus replacement
may need to be removed to treat the infection. You can also develop arthritis at the other joints around the talus, which can lead to continued pain after surgery and possibly the need for more surgery in the future.
What are my alternatives to total talus replacement?
Most patients with avascular necrosis of the talus do not need a total talus replacement. There are various other treatments for avascular necrosis, including medication. Some patients benefit from procedures designed to bring the talus bone back to life,
such as core decompression (drilling into the bone to improve blood supply) and vascularized bone grafting (attaching bone with a good blood supply to the talus bone). It is important to discuss your options with your foot and ankle orthopaedic surgeon.
Whom should I see to have a total talus replacement?
Foot and ankle orthopaedic surgeons have the training and expertise to perform total talus replacements. They can evaluate you to see if you are a good candidate for the procedure or if other procedures might be better for you.
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Original article by Elizabeth Cody, MD
Contributors/Reviewers: Sudheer Reddy, MD
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