Efficacy of 3D-printed customized titanium implants and its clinical validation in foot and ankle surgery

 In foot and ankle surgery, internal fixation was crucial to maintain the stability of bony structure, and bone grafting material is commonly used to treat bone defects. With rapid development of three-dimensional (3D) printing technology, new advances were made in these two aspects. In this study, digital image correlation method (DICM) data of the patient’s ankle via computed tomography (CT) examination were obtained and imported into a series of software. The engineer cooperated with the surgeon to design the customized implants. Ti-6Al-4V spherical metal powder was chosen as raw material and fused together by selective electron beam melting (SEBM), a type of 3D printing technology, to prepare the implant. The implants were sterilized with ethylene oxide. The customized 3D-printed implants were successfully utilized in tibiotalocalcaneal (TTC) arthrodesis to maintain the bony structures at the functional position. In another case, the 3D-printed fusion cage was applied in subtalar arthrodesis to treat bone defects. In these clinical cases, 3D-printed customized titanium implants helped improve the surgical operation flow, and no obvious tissue reaction was observed. The successful implementation suggested that the application of 3D printing technology to prepare customized titanium implants would play an important role in future foot and ankle surgery.