Third Xiangya Hospital Performs Hospital's First 3D-Printed Guide Plate Osteotomy and Autologous Periosteum-Bone Plug Transplantation

Background

Talar cartilage injuries, also known as osteochondral lesions of the talus, frequently occur following ankle sprains. Cartilage has poor self-repair capacity due to limited blood supply, making such injuries a recognized clinical challenge. Two patients, a 38-year-old male referred to as Mr. Jiang and a 43-year-old female referred to as Ms. Pan, both developed recurrent ankle pain after sprains. Conservative treatments proved ineffective, and the pain affected their daily lives and mobility.

What was achieved

On January 26, 2026, the orthopedics foot and ankle team at The Third Xiangya Hospital of Central South University performed the hospital's first combined 3D-printed guide plate osteotomy and autologous periosteum-bone plug transplantation on both patients. The team was led by Deputy Chief Physician Zhang Kexiang, along with attending physicians including Jiang Hao and Xia Hansong. The procedures involved arthroscopic debridement followed by precise osteotomy using a patient-specific 3D-printed guide to access and treat the talar lesions (diagnosed as Hepple type III and V), and transplantation of bone plugs with periosteum harvested from each patient's iliac crest.

Both patients tolerated the surgeries well with stable vital signs. Postoperatively, pain was significantly relieved. Under nursing and rehabilitation guidance, they progressed to functional exercises. One patient was discharged shortly after, with the second expected to discharge the following week. Mr. Jiang stated that his foot no longer hurt and he could walk normally. Sources described this as the hospital's first application of the technique, marking a breakthrough in its foot and ankle surgical capabilities.

How it works

The talus is a key weight-bearing bone in the ankle joint. Damage to its cartilage, often from trauma like sprains, can cause pain, swelling and impaired function. Previous treatments sometimes involved allograft materials, which risk immune rejection, or harvest of cartilage-bone plugs from non-weight-bearing areas of the patient's own joints, which can damage the donor site.

In this procedure, surgeons begin with arthroscopy to thoroughly clear hypertrophic synovium and scar tissue from the ankle joint. A custom 3D-printed guide plate is applied to perform a precise osteotomy on the medial malleolus. This controlled cut exposes the talar defect for complete debridement of damaged tissue. A bone plug covered by periosteum is then harvested from the patient's iliac crest. The periosteum contains growth factors that support repair. The autologous plug is press-fit into the prepared talar lesion. The 3D guide is reported to improve precision, shorten operative time and reduce collateral tissue damage. The iliac crest donor site experiences minimal adverse reactions and can repair itself.

What it means for international patients

The Third Xiangya Hospital opened an International Medical Department in May 2024. It has received foreign patients, beginning with a visitor from New Zealand, and provides English-language medical records, dedicated nurses for full-process coordination, independent examination areas, and streamlined one-stop services. Orthopedics is among the specialties offered. The department is included on Hunan's official list of institutions providing international medical services.

International patients interested in care for conditions such as talar osteochondral lesions should contact the hospital's International Medical Department directly. They must confirm eligibility, current availability of the specific technique, and individual suitability, as these depend on case-specific medical evaluation. No pricing or guarantees of outcomes are reported in available sources.

About the hospital

The Third Xiangya Hospital of Central South University, also known as New Xiangya, is located in Changsha, Hunan Province, at 138 Tongzipo Road, Yuelu District. Founded in 1989, it is a large comprehensive Grade 3A tertiary hospital directly administered by the National Health Commission and affiliated with Central South University. It has approximately 2,200 authorized beds, a building area exceeding 200,000 square meters, and around 3,500 staff members.

The hospital has earned A+ ratings in national performance appraisals for tertiary public hospitals for seven consecutive years, with a best national ranking of 38th. It features strengths in transplantation medicine, minimally invasive surgery and health management. Its orthopedics department includes foot and ankle subspecialty care, has joined a national foot and ankle specialist alliance, and participates in the International Medical Department. It maintains 17 national key clinical specialties or construction projects.