Tantalum cones and bone defects in revision total knee arthroplasty

Boureau, F.; Putman, Sophie; Arnould, A.; Dereudre, G.; Migaud, Henri; Pasquier, Gilles

doi:10.1016/j.otsr.2014.11.020

Cited by 52 publications

(26 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Those implants have several additional advantages: the modulus of elasticity of porous tantalum is similar to that of subchondral bone, allowing greater physiological transfer of load to the host bone; in addition, they are stronger than structural allografts, and have a higher coefficient of friction than traditional cementless designs, resulting in better stability [1–3]. These properties allow these implants to be used in modern orthopaedics in difficult primary and revision hip and knee arthroplasties, foot and ankle surgery or dental implants [4–8]. Trabecular metal implants have also been awarded higher scores in selected arthroplasties than conventional components [9].…”

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: An evaluation of the potential consequences of drilling titanium and tantalum implants during surgery - a pilot study

Skowronek

Olszewski

Święszkowski

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundThe aim of the study was to evaluate the potential consequences of drilling titanium alloy (Ti) and tantalum (Ta) implants.MethodsDuring an in vitro study, four holes were made in each of two spatially porous trabecular implants: one Ta and the other Ti alloy (Ti-6Al-7Nb). The weight and the volume of particles produced during the drilling were then measured using a Radwag XA 110/2X (USA) laboratory balance.ResultsThe loss of mass of the Ti and Ta implants was respectively 1.26 g and 2.48 g, and the volume of free particles was respectively 280 mm3 and 149 mm3. The particles were recovered after each stage. Despite the use of 5 μm filters, around 0.6% of the total implant mass from both implants was not recovered after drilling (roughly 2% of the mass of the particles created).ConclusionIt is technically difficult to make holes in Ti and Ta implants using standard surgical tools, and the process creates a significant amount of metal particles which cannot be removed, despite intensive flushing. This may have a potentially adverse influence on the survival of the implant and result in negative systemic consequences.

show abstract

Section: Discussionmentioning

confidence: 99%

RETRACTED ARTICLE: An evaluation of the potential consequences of drilling titanium and tantalum implants during surgery - a pilot study

Skowronek

Olszewski

Święszkowski

et al. 2017

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Once the cone is impacted into the host bone, the final tibial or femoral component is cemented into the cone. Association of a tibial or femoral stem is useful to guarantee better stability and fixation of the construct ( Figure 5) [50,51,54,55]. Trabecular metal has also been proposed to treat severe patellar bone defect in revision TKA.…”

Section: Tantalum Cones' Surgical Techniquementioning

confidence: 99%

“…Considering the recent introduction of tantalum materials, only short-term follow-up studies are available (Table 4) [54,[57][58][59][60][61][62][63].…”

Section: Clinical Outcomesmentioning

confidence: 99%

Treatment of Bone Losses in Revision Total Hip and Knee Arthroplasty Using Trabecular Metal: Current Literature

Cottino

Rosso

Dettoni

et al. 2016

Journal of Nanomaterials

View full text Add to dashboard Cite

Revision Total Knee or Hip Arthroplasty is challenging procedures for surgeons usually characterized by bone loss. There are different options available to treat those bone losses. However, there is still a concern on the stability of bone-implant interface, which is mandatory to achieve good long-term results in prosthetic implants. Recently, porous tantalum has been introduced, with the aim of improving the bone-implant interface fixation and implant primary stability. Different solutions for the treatment of bone defects in both revision Total Knee and Hip Arthroplasty have been proposed. In revision Total Hip Arthroplasty (THA) tantalum shells can be used to treat Paprosky type III defects also, because of their mechanical properties. Similarly, trabecular metal has been proposed in revision Total Knee Arthroplasty (TKA), being considered a viable option to treat severe type 2 or 3 defects. The aim of this paper is to review the mechanical properties and characteristics of tantalum. Furthermore, we will discuss its role in treating bone defects in both revision THA and TKA, as well as the outcome reported in literature.

show abstract

“…The International Knee Society score ranged from 78 to 143 with authors reporting good alignment and osteointegration at last follow-up. 19 Girerd et al used a similar two-cone technique in 12 cases among their series of 51 patients and though the details regarding demography, etiology, and functional outcomes among these 12 cases were not discussed separately, they reported overall good outcomes with no evidence of loosening in all these cases. 20 We found this technique to be extremely useful when used in the management following wide surgical excision of distal femoral GCTs (►Figs.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2019

J Knee Surg

View full text Add to dashboard Cite

A revision total knee replacement (TKR) poses a challenge relating to management of bone defects, obtaining optimal limb alignment, recreation of joint line, achieving a stable construct to enable early mobilization, and ensuring precise soft tissue tension and flexion-extension gaps. 1,2 Massive iatrogenic bone defect around the knee is also encountered after wide surgical resection of tumors, for example, giant cell tumors (GCTs), involving the epiphyseal-metaphyseal region of distal femur and proximal tibia. There has been a constant endeavor to develop newer techniques to deal with massive bone defects around the knee.Severe distal femoral bone loss, sometimes extending up to the metaphysis and metaphyseo-diaphyseal junction (Anderson Orthopaedic Research Institute [AORI] types 2 and 3) 3 have been previously dealt with by using bulk cementing, impaction bone grafting, structural allografts or autografts, metal augments, trabecular metal (TM) tantalum cones, and sometimes requiring megaprosthesis reconstruction, depending on the Keywords ► stacked trabecular metal cones ► tantalum cones ► revision knee arthroplasty ► distal femoral bone defect AbstractSevere bone loss in distal femur has traditionally been managed with bulk cementing, bone graft, metal augments, trabecular metal cones, and mega prosthesis. The authors present an alternative method using a stacked configuration of two tantalum cones to manage severe distal femoral bone loss. This study aims to evaluate the mid-term outcomes and possible complications in patients treated with this novel technique. We retrospectively analyzed the prospectively maintained records of 16 knees (in 16 patients) presenting with severe distal femoral bone deficiency due to septic loosening (5), giant cell tumor (GCT; 4), periprosthetic fracture (3), aseptic loosening (3), and distal femoral comminuted fracture with severe osteoarthritis (1). A standard medial parapatellar approach was taken in all our cases followed by preparation of distal femoral bone defect and use of two bridging tantalum trabecular metal cones to fill the defect, followed by implantation of rotating hinge knee prosthesis. At an average follow-up of 57 months (4.75 years), the average Knee Society Score was 74.56 (64-87) and the mean range of motion was 97.8 (70-120) degrees. Radiologically, all 16 knees showed good osteointegration with no evidence of progressive radiolucency or loosening. Complications included two patients with superficial infection (healed with antibiotics), and one with recurrence of GCT requiring tumor megaprosthesis reconstruction. The authors concluded that the stacked configuration of cones provides additional coverage and stability with good osteointegration and found it to be particularly useful in distal femoral GCTs and fracture situations. They recommend the use of stacked cones in selected cases of severe distal femoral deficiency.

show abstract

Tantalum cones and bone defects in revision total knee arthroplasty

Cited by 52 publications

References 16 publications

RETRACTED ARTICLE: An evaluation of the potential consequences of drilling titanium and tantalum implants during surgery - a pilot study

RETRACTED ARTICLE: An evaluation of the potential consequences of drilling titanium and tantalum implants during surgery - a pilot study

Treatment of Bone Losses in Revision Total Hip and Knee Arthroplasty Using Trabecular Metal: Current Literature

Untitled

Contact Info

Product

Resources

About