Clinical Validation of a Structural Porous Tantalum Biomaterial for Adult Reconstruction

Bobyn, J. D.; Poggie, Robert A.; Krygier, Jan; Lewallen, David G.; Hanssen, Arlen D.; Lewis, Randall J.; Unger, Anthony S.; O’Keefe, Thomas J.; Christie, Michael J.; Nasser, Sam; Wood, Jeremy; Stulberg, S. David; Tänzer, Michael

doi:10.2106/00004623-200412002-00017

Cited by 278 publications

(169 citation statements)

References 11 publications

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“…Here, we provide a longer-term followup of those patients with the addition of a further 19 patients. Porous trabecular metal, composed of tantalum, has theoretical advantages over conventional porous metals such as titanium, including a high coefficient of friction, a modulus of elasticity closer to that of bone, high volume porosity, and highly interconnected pores resembling the structure of trabecular bone [5,8]. These properties facilitate early implant stability and bone ingrowth combined with predictable and reliable mechanical properties in the long term.…”

Section: Introductionmentioning

confidence: 99%

Continued Good Results With Modular Trabecular Metal Augments for Acetabular Defects in Hip Arthroplasty at 7 to 11 Years

Whitehouse

Masri

Duncan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

107

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Background Reconstruction of large acetabular defects remains a substantial challenge in hip arthroplasty. There remains a paucity of data on the long-term results of acetabular trabecular metal augments. Questions/purposes The purpose of this study was to assess the survivorship, clinical outcomes, restoration of center of rotation of the hip, and radiological signs of component fixation of trabecular metal augments in the context of reconstruction of acetabular defects. Methods Between 2002 and 2005, we performed 56 revision (n = 53) and primary (n = 3) THAs using trabecular metal augments in combination with a trabecular metal acetabular component. Of the 56 patients, 16 (29%) died during followup. Of the 40 surviving patients, 37 (93%) had complete radiological followup, 23 (58%) had complete outcome questionnaire followup, and 17 (42%) provided partial questionnaire responses in the clinic or over the telephone. Median followup was 110 months (range, 88-128 months). During that period, we used these implants when preoperative templating indicated that an augment would be required to achieve acetabular implant stability with restoration of the hip center of rotation. We also chose during surgery to use an augment when we could not achieve a stable acetabular trial component without one. The combination of trabecular metal augments and trabecular metal shells was used in 18% (53 of 292) of our acetabular revisions during that time. Survivorship, functional outcome (WOMAC and Oxford hip score), health status (SF-12), and osseointegration according to the criteria of Moore and presence of radiolucencies were determined.

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Section: Introductionmentioning

confidence: 99%

Continued Good Results With Modular Trabecular Metal Augments for Acetabular Defects in Hip Arthroplasty at 7 to 11 Years

Whitehouse

Masri

Duncan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

107

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“…Porous tantalum is widely used in total hip reconstruction [4], especially for treatment of severe acetabular bone loss during revision hip arthroplasty [4,5,30,37,41]. High volumetric porosity (average 80%), fully interconnected pores, and a low modulus of elasticity (3 GPa) similar to cancellous bone all enhance the potential for bone ingrowth and allow for a more physiologic load transfer with diminished stress shielding [3,8].…”

Section: Introductionmentioning

confidence: 99%

Tantalum Cones Provide Durable Mid-term Fixation in Revision TKA

Martino

Santis

Sculco

et al. 2015

Clin Orthop Relat Res

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Background Multiple studies have reported favorable short-term outcomes using tantalum cones to reconstruct massive bone defects during revision TKA. However, longer-term followup is needed to determine the durability of these reconstructions. Questions/purposes We wished to determine the midterm (1) reoperation rates for septic and aseptic causes, (2) radiologic findings of osseointegration, and (3) clinical outcomes based on the Knee Society score in patients who underwent revision knee arthroplasty with tantalum cones for severe bone loss. Methods We retrospectively evaluated records of 18 patients (18 knees) who underwent revision knee arthroplasty with use of tantalum cones between 2005 and 2008; the primary indications for use of this approach were to reconstruct massive bone defects classified as Anderson Orthopaedic Research Institute Types 2B and 3. During this period, all defects of this type were treated with this approach and no cones were used for more-minor defects. A total of 26 cones (13 tibial and 13 femoral) were implanted. There were 12 female and six male patients with a mean age of 73 years (range, 55-84 years) at the time of revision. The indication for the revision included aseptic loosening (five patients) and second-stage reimplantation for deep infection (13 patients). Patients were followed for a mean of 6 years (range, 5-8 years). No patient was lost to followup. Clinical and radiographic outcomes were assessed with the Knee Society clinical rating system and radiographic evaluation system.

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“…In 2006, our group reported 100% survival in 12 THAs at 2 to 4 years followup with the use of porous tantalum acetabular implants following pelvic radiation therapy [20]. The high coefficient of friction and apparently high ingrowth rates in vivo associated with porous tantalum sockets have made it a potentially important implant material in irradiated bone [1,2,16,17] or complex revision situations [6,8,21]. However, if is unclear whether the high rate of survival initially reported would be maintained.…”

Section: Introductionmentioning

confidence: 99%

Tantalum Acetabular Cups Provide Secure Fixation in THA after Pelvic Irradiation at Minimum 5-year Followup

Joglekar

Rose

Lewallen

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Pelvic radiation has been commonly used to treat gastrointestinal, genitourinary, or hematopoietic malignancies. Conventional THA in these patients reportedly have high rates of fixation failure. Although secure short-term fixation reportedly occurs with trabecular metal implants following pelvic radiation, it is unclear whether the fixation is durable. Questions/purposes We determined the survival of trabecular metal acetabular components in patients having THA following pelvic radiation and assessed function and radiographic loosening. Methods We retrospectively reviewed 29 patients with prior pelvic radiation who had 34 arthroplasties using trabecular metal acetabular components from 1998 and 2005. The mean pelvic radiation dose was 6300 cGy. We collected the following data: patient demographics, surgery and implant information, clinical and radiographic followup, and tumor and radiotherapy related details. We obtained Harris hip scores (HHS) on all patients. Ten patients died of disease prior to 5 years and two patients were excluded, leaving 17 patients (22 hips) with a minimum of 5 years of clinical (mean, 78 months; median, 71; range, 57-116) and radiographic (mean, 73; median, 65; range, 51-116) followup.

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Clinical Validation of a Structural Porous Tantalum Biomaterial for Adult Reconstruction

Cited by 278 publications

References 11 publications

Continued Good Results With Modular Trabecular Metal Augments for Acetabular Defects in Hip Arthroplasty at 7 to 11 Years

Continued Good Results With Modular Trabecular Metal Augments for Acetabular Defects in Hip Arthroplasty at 7 to 11 Years

Tantalum Cones Provide Durable Mid-term Fixation in Revision TKA

Tantalum Acetabular Cups Provide Secure Fixation in THA after Pelvic Irradiation at Minimum 5-year Followup

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