Midterm Results After Tantalum Cones in 1-Stage Knee Exchange for Periprosthetic Joint Infection: A Single-Center Study

Abdelaziz, Hussein; Biewald, Philipp; Anastasiadis, Zoy; Haasper, Carl; Gehrke, Thorsten; Hawi, Nael; Citak, Mustafa

doi:10.1016/j.arth.2019.11.016

Cited by 20 publications

(27 citation statements)

References 20 publications

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“…30 However, our experience with the hinged design in complex reconstructions is encouraging. 31,32 Patient satisfaction and functional outcome scores were not investigated. Lastly, a selection bias exists for all repeat septic revision studies because patients who are deemed unfit for repeat septic revision (one-or two-stage) are not included.…”

Section: Discussionmentioning

confidence: 99%

High revision rates following repeat septic revision after failed one-stage exchange for periprosthetic joint infection in total knee arthroplasty

Neufeld

Liechti

Soto

et al. 2022

The Bone & Joint Journal

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Aims The outcome of repeat septic revision after a failed one-stage exchange for periprosthetic joint infection (PJI) in total knee arthroplasty (TKA) remains unknown. The aim of this study was to report the infection-free and all-cause revision-free survival of repeat septic revision after a failed one-stage exchange, and to determine whether the Musculoskeletal Infection Society (MSIS) stage is associated with subsequent infection-related failure. Methods We retrospectively reviewed all repeat septic revision TKAs which were undertaken after a failed one-stage exchange between 2004 and 2017. A total of 33 repeat septic revisions (29 one-stage and four two-stage) met the inclusion criteria. The mean follow-up from repeat septic revision was 68.2 months (8.0 months to 16.1 years). The proportion of patients who had a subsequent infection-related failure and all-cause revision was reported and Kaplan-Meier survival for these endpoints was determined. Patients were categorized according to the MSIS staging system, and the association with subsequent infection was analyzed. Results At the most recent follow-up, 17 repeat septic revisions (52%) had a subsequent infection-related failure and the five-year infection-free survival was 59% (95% confidence interval (CI) 39 to 74). A total of 19 underwent a subsequent all-cause revision (58%) and the five-year all-cause revision-free survival was 47% (95% CI 28 to 64). The most common indication for the first subsequent aseptic revision was loosening. The MSIS stage of the host status (p = 0.663) and limb status (p = 1.000) were not significantly associated with subsequent infection-related failure. Conclusion Repeat septic revision after a failed one-stage exchange TKA for PJI is associated with a high rate of subsequent infection-related failure and all-cause revision. Patients should be counselled appropriately to manage expectations. The host and limb status according to the MSIS staging system were not associated with subsequent infection-related failure. Cite this article: Bone Joint J 2022;104-B(3):386–393.

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Section: Discussionmentioning

confidence: 99%

High revision rates following repeat septic revision after failed one-stage exchange for periprosthetic joint infection in total knee arthroplasty

Neufeld

Liechti

Soto

et al. 2022

The Bone & Joint Journal

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“…79 There were only two (3.3%) unsuccessful cases resulting from the recurrence of infection, and neither were related to porous Ta cone mechanics. 79 However, porous Ta scaffolds exhibited no considerable superiority in the one-stage revision of prosthesis infection; 81,82 for example, when the porous Ta acetabular augmentation was applied for the one-stage revision of infected total hip arthroplasty (THA), no significant difference was observed between patients using trabecular augments and those not using trabecular augments regarding the re-revision rate due to hematoma, dislocation, and fracture (Figure 7C), 81 and the failure and reinfection rates were 21% and 11.1%, respectively, in the one-stage revision of knee prosthesis infection using porous Ta cones (Figure 7D). 82…”

Section: Clinical Applications Of Ta In Ibds Treatmentmentioning

confidence: 99%

Section: Clinical Applications Of Ta In Ibds Treatmentmentioning

confidence: 99%

Current Advances and Applications of Tantalum Element in Infected Bone Defects

Yao

et al. 2022

ACS Biomater. Sci. Eng.

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Infected bone defects (IBDs) cause significant economic and psychological burdens, posing a huge challenge to clinical orthopedic surgeons. Traditional approaches for managing IBDs possess inevitable shortcomings; therefore, it is necessary to develop new functionalized scaffolds. Tantalum (Ta) has been widely used in load-bearing orthopedic implants due to its good biocompatibility and corrosion resistance. However, undecorated Ta could only structurally repair common bone defects, which failed to meet the clinical needs of bacteriostasis for IBDs. Researchers have made great efforts to functionalize Ta scaffolds to enhance their antibacterial activity through various methods, including surface coating, alloying, and micro-and nanostructure modifications. Additionally, several studies have successfully utilized Ta to modify orthopedic scaffolds for enhanced antibacterial function. These studies remarkably extended the application range of Ta. Therefore, this review systematically outlines the advances in the fundamental and clinical application of Ta in the treatment of IBDs, focusing on the antibacterial properties of Ta, its functionalization for bacteriostasis, and its applications in the modification of orthopedic scaffolds. This study provides researchers with an overview of the application of Ta in the treatment of IBDs.

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“…4 ). 9 10 11 12 13 14 15 16 More recently, 3D-printed titanium cones have been developed with associated proprietary bone preparation instrumentation. These have demonstrated similar stability in both the femur and tibia 17 and promising short-term results 18 19 20 ; however, mid- and long-term results have yet to be revealed.…”

Section: Zone 2: the Metaphysismentioning

confidence: 99%

Zonal Fixation in Revision TKA: The Key Is Metaphyseal Fixation

Scuderi²

2021

J Knee Surg

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As the volume of primary total knee arthroplasties continues to rise, so will the volume of revision arthroplasties. Bone loss is commonly encountered in revision surgery and must be managed appropriately to optimize outcomes. The concept of zonal fixation highlights the importance of attaining secure fixation within each of the three major osseous zones: the epiphysis, the metaphysis, and the diaphysis. While each zone is important, the metaphysis carries particular significance. The development of new implants such as metaphyseal cones and sleeves has greatly expanded the orthopedic surgeon's armamentarium to allow for solid metaphyseal fixation in virtually every case.

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Midterm Results After Tantalum Cones in 1-Stage Knee Exchange for Periprosthetic Joint Infection: A Single-Center Study

Cited by 20 publications

References 20 publications

High revision rates following repeat septic revision after failed one-stage exchange for periprosthetic joint infection in total knee arthroplasty

High revision rates following repeat septic revision after failed one-stage exchange for periprosthetic joint infection in total knee arthroplasty

Current Advances and Applications of Tantalum Element in Infected Bone Defects

Zonal Fixation in Revision TKA: The Key Is Metaphyseal Fixation

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