Porous Tantalum Tibial Component Prevents Periprosthetic Loss of Bone Mineral Density After Total Knee Arthroplasty for Five Years—A Matched Cohort Study

Minoda, Yukihide; Kobayashi, Akio; Ikebuchi, Mitsuhiko; Iwaki, Hiroaki; Inori, Fumiaki; Nakamura, Hiroaki

doi:10.1016/j.arth.2013.03.031

Cited by 35 publications

(43 citation statements)

References 22 publications

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“…There were no radiolucencies noted in the cemented group. These radiolucencies were seen at a higher rate than the non-modular trabecular metal designs reported in the literature, that demonstrate through RSA studies some minimal early migration but excellent osseous integration and no progressive or significant radiolucencies [7,9,10,13,[22][23][24]. The modular trabecular metal tibial plates in this study had non-progressive radiolucencies in 7 knees and 4 knees had an average of 3°varus subsidence with subsequent stabilization and osseointegration.…”

Section: Discussionmentioning

confidence: 53%

To Cement or Not? Two-Year Results of a Prospective, Randomized Study Comparing Cemented Vs. Cementless Total Knee Arthroplasty (TKA)

Fricka

Sritulanondha

McAsey

2015

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 53%

To Cement or Not? Two-Year Results of a Prospective, Randomized Study Comparing Cemented Vs. Cementless Total Knee Arthroplasty (TKA)

Fricka

Sritulanondha

McAsey

2015

The Journal of Arthroplasty

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“…At a minimum 5 years followup, a prospective analysis of 100 patients aged \ 55 years with an uncemented trabecular metal tibia by Kamath et al [6] found 97% survival for all causes and 100% survival with aseptic loosening of the tibia as the endpoint. Also at 5 years followup, a matched-cohort study of uncemented trabecular metal tibia versus a traditional cemented modular tibia was done in Japan by Minoda et al [10]. They used dual x-ray absorptiometry in addition to plain radiographs for assessment of implant migration and bone density.…”

Section: Discussionmentioning

confidence: 99%

“…In that analysis, there was no difference in the reliability of the uncemented trabecular metal tibia at 1 year or 5 years based on patient age as stratified into three categories, namely age \ 55 years, age 55 to 65 years, and age [ 65 years with [ 97% survival free of reoperation in each group. Minoda et al from Japan performed a matched-pair cohort study of patients with an uncemented trabecular metal tibia compared with a group with a traditional cemented modular tibia using age, sex, weight, height, and diagnosis as the matching criteria [10]. At 5 years followup, there were no differences between the groups in terms of clinical scores as assessed by the Knee Society score, no differences in final ROM, and no differences in regard to component migration or the risk of periprosthetic fracture.…”

Section: Discussionmentioning

confidence: 99%

The Mark Coventry Award

Pulido

Abdel

Lewallen

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Although highly porous metals have demonstrated excellent bone ingrowth properties and so are an intriguing option for fixation in total knee arthroplasty (TKA), some surgeons are skeptical about the durability of uncemented tibial fixation and the potential for soft tissues to adhere to these porous metals and perhaps cause knee stiffness or pain. Questions/purposesThe purpose of this study was to compare, in the context of a randomized clinical trial, a highly porous metal tibia compared with a traditional modular cemented tibia in terms of survivorship, Knee Society scores, range of motion (ROM), and complications. MethodsFrom 2003 to 2006, 397 patients (age 67.8 ± 8.7 years; 54% female) were randomized to three groups: (1) traditional modular cemented tibia; (2) cemented highly porous metal tibia; and (3) uncemented highly porous metal tibia. The same posterior-stabilized femoral component and patella component were cemented in every case. Stratified randomization was done for surgeon, patient's age, sex, and body mass index. Survivorship at 5 years was compared between the groups, as were Knee Society scores, ROM, and complications. Radiographic assessment included alignment, radiolucency, and implant migration/loosening. Patients were followed until death, revision, or for a minimum of 2 years (mean, 5 years; range, 2-9 years). Four patients were lost to followup before 2 years. ResultsHighly porous metal tibias (both uncemented and cemented) were no different from traditional cemented modular tibial modular components in terms of survivorship at 5 years using a intention-to-treat analysis (96.8% [1]; 97.6% [2]; 96.7% [3]; p = 0.59). A per-protocol analysis revealed that no highly porous metal tibia was revised for aseptic loosening. Highly porous metal tibias performed comparably to traditional cemented modular tibias in terms of Knee Society scores, ROM, and the frequency of complications. ConclusionsAt 5 years this randomized clinical trial demonstrated that highly porous metal tibias provided comparably durable fixation and reliable pain relief and restoration of function when compared with a traditional cemented modular tibia in TKA.

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“…They observed 100 % survivorship of the tibial components with no evidence of osteolysis or change in periprosthetic bone density. Minoda et al demonstrated favorable results of porous tantalum tibial components on bone mineral density of the proximal tibias in a matched cohort at 5-year follow-up [ 61 ]. In summary, monoblock tibial components have shown excellent midterm durability in primary TKR.…”

Section: Knee Reconstructive Surgerymentioning

confidence: 89%

“…Recent clinical studies have also shown a potential advantage of tantalum devices in preventing stress shielding following implantation in knee replacement surgeries [ 61 ]. The use of tantalum implants has been extended to spine surgeries and osteonecrosis of hip with mixed results.…”

Section: Future Trendsmentioning

confidence: 98%

The Use of Porous Tantalum for Reconstructing Bone Loss in Orthopedic Surgery

Patil¹,

Goodman

2015

Springer Series in Biomaterials Science and Engineering

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Porous tantalum, a novel biomaterial, was approved for use in orthopedic surgery by the Food and Drug Administration (FDA) in 1997. Several preclinical and experimental studies have demonstrated excellent biocompatibility with physical, mechanical, and tissue ingrowth properties conducive for enhanced osseointegration and superior structural integrity. Porous tantalum has high volumetric porosity (75-80 %). The modulus of elasticity of tantalum (3 Gpa) compares favorably to cancellous bone (1.2 GPa) or subchondral bone (2 GPa). Porous tantalum also has a high coeffi cient of friction with a high resistance to compression (50-80 Mpa) and rotational deformity (40-60 Mpa). Tantalum has been used in a wide array of clinical applications in orthopedics including primary and revision joint replacement, tumor reconstructive surgery, spine fusion, management of osteonecrosis of the femoral head, and foot and ankle surgery. Recent studies have demonstrated excellent clinical and radiographic outcomes, even in the presence of extensive bone loss in hip and knee reconstructive surgeries. Its use in spine surgeries and osteonecrosis of the hip has been associated with mixed clinical results. Further clinical studies are necessary to establish its role and refi ne its indications in specifi c orthopedic applications and determine whether the theoretical advantages of porous tantalum can provide long-term biological fi xation and stability. This chapter presents a synopsis of the biomaterial properties and preclinical and clinical studies of porous tantalum in orthopedic surgery.

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Porous Tantalum Tibial Component Prevents Periprosthetic Loss of Bone Mineral Density After Total Knee Arthroplasty for Five Years—A Matched Cohort Study

Cited by 35 publications

References 22 publications

To Cement or Not? Two-Year Results of a Prospective, Randomized Study Comparing Cemented Vs. Cementless Total Knee Arthroplasty (TKA)

To Cement or Not? Two-Year Results of a Prospective, Randomized Study Comparing Cemented Vs. Cementless Total Knee Arthroplasty (TKA)

The Mark Coventry Award

The Use of Porous Tantalum for Reconstructing Bone Loss in Orthopedic Surgery

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