Three-dimensional (3D)-printing technology is revolutionizing orthopedic oncology by providing precise, customized solutions for complex bone defects following tumor resection. Traditional modular endoprostheses are prone to complications such as fretting corrosion and implant failure, underscoring the need for innovative approaches. This case series reports on three patients treated with 3D-printed, patient-specific prostheses and cutting guides. Preoperative CT and MRI data were used to design implants tailored to each patient's anatomy, manufactured using electron beam melting technology with a titanium-aluminum-vanadium alloy. Functional outcomes showed significant improvements: in Case I, AOFAS improved from 71 to 96, and VAS decreased from 6 to 1; in Case II, AOFAS increased from 65 to 79, and VAS decreased from 5 to 3. Radiographic evaluations demonstrated stable prosthesis placement and early evidence of bone integration in Cases I and II, while in Case III, localized disease control was achieved before systemic progression. This case series highlights the transformative potential of 3D-printed prostheses in addressing the challenges of reconstructing anatomically complex defects. By enabling precise tumor resection and improving functional outcomes, this approach can advance current practices in orthopedic oncology. Further research should explore larger cohorts and use cost-effectiveness analyses to validate these findings and facilitate broader clinical adoption.

Bone peg fixation for osteochondral lesions of the talus showed satisfactory clinical and radiographic results, without complications. This technique could be a good form of treatment for patients with this condition who have an osteochondral fragment. Cite this article: <i>Bone Joint J</i> 2020;102-B(10):1349-1353.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Three-dimensional (3D)-printing technology is revolutionizing orthopedic oncology by providing precise, customized solutions for complex bone defects following tumor resection. Traditional modular endoprostheses are prone to complications such as fretting corrosion and implant failure, underscoring the need for innovative approaches. This case series reports on three patients treated with 3D-printed, patient-specific prostheses and cutting guides. Preoperative CT and MRI data were used to design implants tailored to each patient's anatomy, manufactured using electron beam melting technology with a titanium-aluminum-vanadium alloy. Functional outcomes showed significant improvements: in Case I, AOFAS improved from 71 to 96, and VAS decreased from 6 to 1; in Case II, AOFAS increased from 65 to 79, and VAS decreased from 5 to 3. Radiographic evaluations demonstrated stable prosthesis placement and early evidence of bone integration in Cases I and II, while in Case III, localized disease control was achieved before systemic progression. This case series highlights the transformative potential of 3D-printed prostheses in addressing the challenges of reconstructing anatomically complex defects. By enabling precise tumor resection and improving functional outcomes, this approach can advance current practices in orthopedic oncology. Further research should explore larger cohorts and use cost-effectiveness analyses to validate these findings and facilitate broader clinical adoption.

Bone peg fixation for osteochondral lesions of the talus showed satisfactory clinical and radiographic results, without complications. This technique could be a good form of treatment for patients with this condition who have an osteochondral fragment. Cite this article: <i>Bone Joint J</i> 2020;102-B(10):1349-1353.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

The thrombin-based hemostatic agent demonstrated efficacy in reducing drain output and blood transfusion rates. Thus, we believe the use of a thrombin-based hemostatic agent should be considered as an option in orthopedic surgery that involves massive bleeding.

All the selected models achieved kappa values of 0.6 or higher, indicating substantial agreement, and the AUC score for classifying standard images based on the total score was 0.89. The activation map of the trained models properly reflected the structural features of the image. The time lapse for standard image classification was 0.35 second per image in full sequence method, and that of the three versions - ASM-1, ASM-2, ASM-3 - were 0.27, 0.22, and 0.20, respectively.

As a total ankle replacement (TAR) prosthesis has been developed and improved in terms of design and surgical technique, it could be expected to lead to a successful functional outcome in the ankle joint. However, several complications of the TAR procedure may be often caused by an incomplete understanding of the abnormal biomechanics of the ankle joint and the prosthesis design of the TAR. This study was performed to suggest a novel approach to determine the TAR prosthesis size by using an orthopedic digital templating software based on a comparison between X-ray and CT images. This study was examined in a novel approach to determine the prosthesis size by using an orthopedic digital templating software (Orthoview™, Florida, USA) based on the comparison between X-ray and CT images. A total 6 types of clinical foot and ankle images were obtained from x-ray and CT of 55 subjects in the coronal and sagittal plane. The x-ray images magnified as 100% and 115% based on the CT images. All subjects were diagnosed to the ankle osteoarthritis with stage 2-4 according to Takakura's ankle OA classification. To predict the appropriate component sizes of the TAR prosthesis, the same TAR prosthesis (HINTEGRA, Newdeal, France) was chosen, and the tibial and the the talar component sizes were selected until by adapting to the osteotomized range of the tibia and talus. The unskilled surgeons predicted the sizes of the TAR components before procedure by using the orthopedic digital templating software. These predicted sizes were then compared with the selected sizes by the specialist surgeon during the procedure. The Cohen's Kappa correlation coefficient was applied to statistically analyze the agreement between the predicted and selected sizes of the TAR components for unskilled and specialist surgeons, respectively. On the CT images, the average agreement rate was relatively higher than on the x-ray images at over 77%. Especially, highest agreement rate was shown at the tibial component in the coronal plane with almost 80%, followed by over 75% in the sagittal plane. In the talar part, the agreement rate was shown to be over 76% in the coronal and sagittal plane, respectively. Overall, the predicted size from the CT image was more consistent with the size selected by the specialist surgeon than the X-ray image. In conclusion, the application of the orthopedic digital templating software based on CT images may expect to provide more complete and detailed visualization to predict the appropriate size of the TAR components than conventional X-ray images which would be limited by relatively lower sensitivity and specificity as well as overlapping the adjacent bones.

<b>Background:</b> Syndesmotic instability presents a significant challenge in orthopedic surgery, with no universally accepted treatment approach. Traditional methods, such as trans-syndesmotic screw fixation, remain widely used but are associated with complications, including malreduction, hardware-related issues, and restricted physiological motion. Recent advancements in flexible dynamic fixation, particularly suture tape augmentation, offer promising alternatives by preserving native biomechanics and enabling early rehabilitation. <b>Methods:</b> This technical note details an anterior-to-posterior syndesmotic augmentation technique using suture tape to address unstable syndesmotic injuries involving both the anterior inferior tibiofibular ligament and posterior inferior tibiofibular ligament. The proposed technique aims to restore stability, reduce complications, and improve functional outcomes. <b>Results:</b> The technique eliminates the need for hardware removal, supports early weight-bearing, and minimizes postoperative limitations. <b>Conclusions:</b> Anterior-to-posterior syndesmotic augmentation with suture tape represents a viable alternative for syndesmotic instability. Further clinical and biomechanical studies are warranted to validate its long-term efficacy and applicability across diverse patient populations.

In conclusion, both titanium and ceramics have excellent biocompatibility for artificial joints, and ceramic materials can be used as novel artificial joints. Further research on the strength and availability of these ceramics is required.