3D Printed Total Talar Replacement: A Promising Treatment Option for Advanced Arthritis, Avascular Osteonecrosis, and Osteomyelitis of the Ankle.

Advanced ankle arthritis, avascular osteonecrosis, and osteomyelitis of the ankle remain a surgical challenge in the foot and ankle arena with limited treatment options. Multiple medical comorbidities contribute to total loss of the talus. Collapse of the talar body as a complication of total ankle arthroplasty, talectomy in infection, and septic talus necrosis or severe bone defects caused by tumor resection may result in need for total talar replacement. Ankle arthrodesis and tibiocalcaneal fusion after talectomy can produce severe disability of the ankle and foot. Total ankle replacement is a viable option for treatment of end-stage ankle arthritis in appropriate patient populations

Minimally Invasive Bunion Correction.

Hallux valgus is a common condition that results in lateral deviation of the hallux and medial deviation of the metatarsal. When conservative management fails, surgical management is often necessary. More than 150 procedures have been described, and most recommend an open approach. More recently, a minimally invasive approach to bunion correction has gained popularity among surgeons. The authors have been performing a minimally invasive percutaneous method of bunion correction with positive outcomes. This article presents case examples and a systematic approach for correction of this common foot condition

Lengthen, Alignment, and Beam Technique for Midfoot Charcot Neuroarthropathy.

Charcot neuroarthropathy is a disabling pathology in the foot and ankle. Midfoot Charcot is most common and results in progressive deformity. We describe a 2-step approach to surgical reconstruction, referred to as the lengthen, alignment, and beam technique. There is an initial surgery involving acute equinus correction through Achilles tendon lengthening and gradual correction with hexapod external fixation to align the deformity, followed by minimally invasive medial and lateral column beaming. This surgical protocol allows for adequate reduction of deformity. The second stage allows for rigid intramedullary fixation extending beyond the pathologic joints via a minimally invasive technique

Subchondroplasty: Treatment of Bone Marrow Lesions in the Lower Extremity.

Bone marrow lesions are associated with pain, disease progression, and cartilage loss in inflammatory and noninflammatory conditions, and are related to mechanical loading and subchondral stress. Treatment, particularly in the foot and ankle, is challenging. In the subchondroplasty procedure, flowable, synthetic, calcium phosphate bone filler is injected into the defect region, improving subchondral bone integrity and allowing remodeling back into healthy cancellous bone. The procedure is a promising treatment option for bone marrow lesions, particularly in the foot and ankle. The benefits are a minimally invasive procedure with early return to weightbearing