Systematic Review Examines Contributors to the Success of 3D-Printed Talar Implants
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What contributing factors play a role in outcomes for 3D-printed talar implants? A recent oral abstract presented at the 2025 American Podiatric Medical Association National conference addressed this question. The lead author, Camellia Russell, MBA, shared her teams’ findings with Podiatry Today.
Ms. Russell and colleagues designed their systematic review to investigate whether patient-specific factors (age, sex, and comorbidities) are predictors of success with 3D-printed talus implants.1
“The role of 3D models in ankle reconstruction has been well studied, but the published data are frequently not stratified to account for patient-specific variables,” she noted. “We wished to analyze whether the “custom-fit” leads to a “better fit” regardless of the patient population, or if certain subsets of patients have better or worse surgical results and rates of complications.”
She shared that they systematically reviewed the literature in PubMed, the Journal of Foot and Ankle Surgery, the Journal of the American Podiatric Medical Association, and the Cochrane, and Scopus databases with key terms including “3-D talus modeling,” “total ankle replacement,” “patient outcomes,” and other variants.1 They included literature between 2010 and 2024, focusing on randomized controlled trials, cohort, and case-control studies. They then extracted and collated themes around the comparison of recovery rates by age groups, anatomical differences by sex, and impaired healing in patients with various comorbidities.1
“Our review identified that patient-specific factors play a crucial role in the success of 3D-printed talus implants,” said Ms. Russell. “Younger patients with healthier tissue and fewer comorbidities exhibited improved surgical outcomes and quicker recovery times. Conversely, older individuals and those with comorbid conditions such as diabetes, osteoporosis, or cardiovascular disease experienced higher complication rates. Furthermore, anatomical variations between male and female taluses affected implant fit and performance. These insights underscore that 3D modeling’s impact on customization and outcomes is not uniform across different patient demographics, underscoring the importance of tailored surgical planning.”
Utilizing this information, Ms. Russell and team advocated for DPMs to implement a more patient-centric approach to both surgical planning and ultimately to 3D-printed talus implant application.
“DPMs should not view 3D modeling as an automated process that is completely devoid of surgeon input,” she explained. “During the preoperative planning phase, a podiatric surgeon should consider several important demographic and health-related variables (such as the study factors of age, sex, and comorbidities). This can allow the surgeon to create a more patient-tailored design (if necessary), predict healing rates, and account for potential postop risk factors. This information can then be used to provide the highest standard of evidence-based, patient-centric care, while also reducing the risks of these complex surgical procedures.”
Reference
1. Russell C, Russell M; Birdwell T. The Effectiveness of 3-D Talus Modeling Varies By Patient Factors Like Age, Sex, and Comorbidities: A Systematic Review. Oral abstract presented at the APMA National, July 24-27, 2025, Grapevine, TX.
