Asymmetric ankle osteoarthritis, whether congenital or posttraumatic, develops from disruption of the mechanical axis and leads to progressive joint degeneration. Supramalleolar osteotomy (SMO) is a joint-preserving procedure that restores alignment and redistributes joint-loading forces. However, conventional fixation often involves bulky implants or external fixators, resulting in excessive surgical trauma, high metal consumption, and prolonged rehabilitation. The optimal fixation strategy for SMO remains a topic of debate. We present a 54-year-old woman with asymmetric ankle osteoarthritis and a 13-degree varus deformity of the tibia. The patient underwent a minimally invasive SMO stabilized with a customized low-profile titanium mini-plate. Postoperative radiographs confirmed restoration of the mechanical and anatomical tibial axes and correction of the varus deformity. At the 2-month follow-up, functional outcomes improved markedly. The AOFAS ankle-hindfoot score increased from 56 preoperatively to 86 postoperatively, the Visual Analog Scale (VAS) for pain decreased from 7/10 to 2/10, and the Foot and Ankle Disability Index (FADI) improved from 58% to 88%. No complications were observed. This case highlights the potential of a customized low-profile mini-plate to achieve stable fixation with minimal implant use and reduced surgical trauma. The approach allowed early mobilization, symptomatic relief, and functional recovery within a short follow-up period. Although the favorable short-term outcome supports the feasibility of this minimally invasive method, further studies with larger cohorts and longer follow-up are needed to validate its effectiveness and cost-efficiency compared with traditional fixation techniques.

Background/Objectives: Periprosthetic infection remains a major challenge in orthopedic implantation, particularly for porous titanium implants that promote bone integration but may also facilitate bacterial colonization. This study evaluated magnetron-sputtered tantalum–copper (TaCu) and niobium–copper (NbCu) coatings on Ti6Al4V implants following Staphylococcus aureus challenge, with particular attention to implant geometry. Methods: TaCu-coated, NbCu-coated, and uncoated Ti6Al4V implants with dense (smooth) or porous (rough) geometries were evaluated. Cytocompatibility was assessed using rat mesenchymal stromal cells exposed to implant-conditioned media, and Cu release was measured by ICP-MS. Twenty-four rabbits received femoral implants followed by local S. aureus inoculation. Outcomes were assessed by clinical observation, macroscopic examination, radiography, and confocal microscopy. DAPI-positive structures were analyzed three-dimensionally using a 100 μm³ volume threshold and sensitivity analysis. Results: Neither TaCu- nor NbCu-conditioned media adversely affected MSC metabolic activity, and both coatings released measurable Cu. Despite infection across groups, TaCu-coated implants showed the greatest preservation of implant retention. Analysis of 6,248 segmented objects from 21 animals showed significant associations of coating and implant geometry with the proportion of small DAPI-positive objects (both p < 0.001). Uncoated Ti6Al4V showed higher proportions than NbCu and TaCu (Holm-adjusted p < 0.001), whereas TaCu and NbCu did not differ (p = 0.731). Rough implants showed higher proportions than smooth implants, and the coating-related pattern persisted across thresholds of 25–200 μm³. An additional analysis using a 5 µm³ threshold confirmed differences in the relative proportions of very small DAPI-positive objects (p = 0.0156), whereas total volumetric object density did not differ significantly among coating groups (p = 0.769). Conclusions: Cu-containing coatings altered the distribution of implant-associated DAPI-positive structures without adversely affecting MSC metabolic activity. TaCu showed the greatest preservation of implant retention despite a confocal profile comparable to NbCu, supporting further investigation of TaCu for infection-resistant orthopedic implants.

Травматология және ортопедия салаға батпалы фиксаторлар және жаңа биометаллдық қорытпалар сияқты заманауи технологияларды енгізу, емдеу тәсілдерін сапалы өзгертуге әсер етті, бірақ импланттарды өндіру, және жаңа материалдарды пайдалану мәселесі өзекті болып қала береді. Зерттеу мақсаты. Титан, тантал және ниобий қорытпасының (Ti21Nb6Ta) биоүйлесімділігін in vitro зерттеу. Зерттеу әдістері. Зерттеуде TNT (Ti21Nb6Ta) және BT-6 (Ti-6Al-4V) сулы сығындыларының MTT-сынағы арқылы in vitro адамның фибробласттары мен периостальды жасушаларына уытты әсері зерттелді; TNT және BТ-6 қорытпаларының гемолитикалық белсенділігін – тәжірибелік жануарлардың Wistar егеуқұйрықтары қанындағы әсерін спектрофотометрия әдісімен (in vitro) зерттелді; Пирогендік белсенділік кинетикалық хромогендік әдіспен зерттелді. Зерттеу объектісі TNT (Ti21Nb6Ta) және ВT-6 (Ti-6Al-4V) (бақылау тобы) металл қорытпалары болып табылады. Нәтижелер. In vitro зерттеулер TNT және ВT-6 металл қорытпаларынан алынған сулы сығындылардың өсірілген адамның фибробласттарына және in vitro периостальды жасушаларына цитотоксикалық әсер етпейтінін көрсетті. ТNТ және ВТ-6 қорытпаларының сулы сығындыларының гемолитикалық және пирогендік белсенділігі жоқ екені анықталды. Қорытындылар. Жүргізілген зерттеулер TNT қорытпасының қауіпсіздігі мен биоүйлесімділігінің жоғары деңгейін көрсетеді, бұл in vitro сынақтарының жиынтығымен дәлелденді. Жалпы қабылданған гигиеналық классификацияға сәйкес TNT (Ti21Nb6Ta) және ВT-6 (Ti-6Al-4V) металл қорытпаларын 4-ші қауіптілік клаcсы – төмен қауіпті заттарға жатқызуға болады (ГОСТ 12.1.007-76).

The integration of modern technologies like intramedullary fixators and advanced biometallic alloys has revolutionized traumatology and orthopedics. While these innovations have improved treatment, the exploration of new materials for implants persists. Tantalum and niobium, both non-toxic with similar properties, are preferred for titanium-based biomedical alloys due to their exceptional biocompatibility and corrosion resistance. Acting as stabilizers in titanium alloys, they form passive oxide layers resisting corrosion and remain compatible with biological systems. The novel Ti21Nb6Ta (TNT) alloy promises enhanced osteosynthesis outcomes. Our in vivo research on experimental animals evaluated the biocompatibility and osteoinduction of TNT compared to Ti-6Al-4V (BT-6) alloy (control group). The study comprised three experiments across different animal species, assessing acute toxicity, irritant effects, and long-term biocompatibility and osteoinduction through simulated osteosynthesis. Results indicated that aqueous extracts from both alloys were non-toxic and non-irritating. Furthermore, both demonstrated high biocompatibility and active osteoinduction potential after three months of implantation.