Use of custom 3D polyethylene-ether ketone ketone (PEKK) spacer in the treatment of Charcot neuroarthropathy: A case report

Charcot neuroarthropathy poses a surgical challenge in individuals of all populations. We report a case of a 79-year-old male with Charcot neuroarthropathy and a painful rearfoot varus deformity of the left rearfoot and ankle, who underwent a novel reconstructive procedure. The patient had previously failed conservative treatment and deferred a below-knee amputation in favor of surgical correction. The surgical approach included left ankle arthrodesis, subtalar joint arthrodesis, talectomy, insertion of a tibiotalocalcaneal nail (TTC), and placement of a custom poly-ether-ketone-ketone (PEKK) spacer implant. The surgical approach aimed to stabilize the joint, restore length and alignment, and facilitate healing through autogenous bone grafting and advanced biological materials. No intraoperative or postoperative complications occurred, and postoperative plain film radiographs confirmed correct implant placement and improved rearfoot alignment. Three years postoperatively, the patient had no pain and was able to bear weight on his stable, plantigrade foot without difficulty. This case provides an insight of the applicability of multi-component surgical reconstruction in challenging Charcot deformities with bone loss and rearfoot involvement.