Tantalum is a good bone graft substitute in tibial tubercle advancement

Abstract

Background Porous tantalum is reportedly a good substitute for structural bone graft in several applications. So far, its use has not been reported in tibial tuberosity anteriorization (TTA) for treatment of isolated degenerative chondral lesions of the patellofemoral joint. Questions/Purposes We asked whether the use of this material would produce similar standardized functional scores, pain (VAS), fusion rates, complications, and patient satisfaction to those for bone graft. Patients and Methods We performed a randomized, controlled trial in 101 patients (108 knees) scheduled for TTA comparing a porous tantalum implant (57 knees) with an autologous local tibial bone graft (51 knees). The minimum followup was 5 years (mean, 6.2 years; range, 5-8 years).

Biomechanical testing of a β-tricalcium phosphate wedge for advancement of the tibial tuberosity

“…During our study, the stability of the foam relied only on its high coefficient of friction (18,19). This phenomenon has been described in humans after advancement of the tibial tuberosity with porous tantalum and allows early mobilization and rehabilitation (15). Clinically, the effect of friction will be enhanced by tissue growth into the pores conferring even better stability (15).…”

“…This procedure uses fewer implants and does not necessitate elevation of the periosteum and so permits improved preservation of the blood supply necessary for bone healing. Based on this technique and the recent description of tantalum implants for tibial tuberosity advancement in humans, the use of a porous titanium foam block was developed to replace the cage (15,16). The concept of porous metal in veterinary medicine is not new and has been widely used in cementless hip prostheses for decades.…”

“…This phenomenon has been described in humans after advancement of the tibial tuberosity with porous tantalum and allows early mobilization and rehabilitation (15). Clinically, the effect of friction will be enhanced by tissue growth into the pores conferring even better stability (15). Despite the advantages of porous titanium foam wedge for MMT, an ideal implant would be resorbable.…”

Biocompatible Porous Tantalum Metal Plates in the Treatment of Tibial Fracture

“…In recent years, porous tantalum metal has attracted considerable attention among material scientists and clinicians because of its excellent corrosion resistance and outstanding biocompatibility. In clinical observations, porous tantalum bone implanted devices exhibited excellent biocompatibility, and the porous tantalum and bone tissues were found to form strong binding with excellent long‐term stability.…”

Proximal Humeral Nonunion Treated With an Intramedullary Tantalum Cylinder

“…Metallic implants that promote bony ingrowth are not a new concept. Tantalum implants have been used in spine surgery, 16 as bone graft substitutes in tibial tubercle advancement, 17 and in revision total joint replacement. 18,19 They offer many potential advantages in nonunion surgery.…”