Total Talus Replacement: A Custom Answer to an Unsolved Problem

The talus carries the body's load between tibia and foot, articulating with four bones — and its precarious retrograde blood supply is why talar neck fractures carry a high risk of avascular necrosis. A dead or destroyed talus historically meant arthrodesis and a stiff, painful foot.

The custom total talus

A patient-specific total talus is 3D-printed in titanium from the patient's CT — and, importantly, the mirror of the healthy contralateral talus where one exists. It reproduces the native articular geometry for the tibial plafond, malleolar facets, subtalar and talonavicular joints, preserving whatever motion those joints still have. Porous lattice zones promote ingrowth; articular surfaces are polished low-friction.

Outcomes and rehabilitation

Early series report meaningful pain relief and preservation of functional, if reduced, ankle and subtalar motion in the majority of cases — versus none after fusion. Rehabilitation is gradual: protected loading while ingrowth matures, then progressive motion and proprioceptive work. The talus is among the most demanding cases we design; contact us via the case form and we will advise candidly whether a custom implant or fusion remains the better option.