Mid-Term Survivorship, Performance, and Predictors of Outcome in Primary Total Hip Arthroplasty With a Porous Tantalum Femoral Prosthesis

Akram, Faisal; Kunze, Kyle N.; Kerzner, Benjamin; González, Alejandro; Palacios, Arnold R.; Levine, Brett R.

doi:10.1016/j.arth.2020.12.001

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…It is worth noting the osteogenic and angiogenic genes expressions of BMSCs co-cultured and seeded on P600 porous scaffold were significantly higher than others, which may be explained by the mechanical transmission mechanism ( Murphy et al, 2010 ; Van Bael et al, 2012 ). The in vivo experiment confirms the in vitro results, which further verifies the deduction the wettability, permeability, elastic modulus, and strength synergistically influence the osteoinduction and osteogenesis behavior of the porous scaffold ( Houdek et al, 2020 ; Akram et al, 2021 ). The porous scaffolds with a pore size of 600 μm possess the better capability to induce new bone formation, due to their well-balanced physical and mechanical properties.…”

Section: Discussionsupporting

confidence: 82%

Improving osteoinduction and osteogenesis of Ti6Al4V alloy porous scaffold by regulating the pore structure

Wang

Liu

et al. 2023

Front. Chem.

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Titanium alloy scaffolds with a porous structure have attracted much attention in bone defect repair. However, which pore structure is more beneficial to bone defect repair is controversial. In the present research, the Ti6Al4V alloy porous scaffolds with gradient pore sizes were designed and fabricated. The microstructure characterization, tests of mechanical properties, and in vitro and in vivo experiments have been performed to systematically evaluate the effect of pore size on osteoinduction and osteogenesis. The results revealed that the contact angle with water, compressive strength, and elastic modulus of the Ti6Al4V alloy porous scaffolds decreased gradually with the increase of pore size. However, there were obvious drops when the pore size of the porous scaffold was around 600 μm. As the pore size increased, the proliferation and integrin β1 of RAW 264.7 macrophages seeded on Ti6Al4V alloy porous scaffolds increased at first, reaching a maximum value at a pore size of around 600 μm, and then decreased subsequently. The proliferation, integrin β1, and osteogenic gene-related expressions of Bone marrow mesenchymal stem cells (BMSCs) seeded on Ti6Al4V alloy porous scaffolds with different pore sizes all exhibited similar variations which rose with increased pore size firstly, obtaining the maximum value at pore size about 600 μm, and then declined. The in vivo experiments confirmed the in vitro results, and the Ti6Al4V alloy porous scaffold with a pore size of 600 μm possessed the better capability to induce new bone formation. Therefore, for the design of Ti6Al4V alloy with a regular porous scaffold, the surface morphology, porosity, strength, and elastic modulus should be considered systematically, which would determine the capability of osteoinduction and osteogenesis.

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Section: Discussionsupporting

confidence: 82%

Improving osteoinduction and osteogenesis of Ti6Al4V alloy porous scaffold by regulating the pore structure

Wang

Liu

et al. 2023

Front. Chem.

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“…A number of studies have already investigated the potential of BMI and weight as a factor affecting stem loosening and revealed different findings for different stem types [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. According to Bergmann et al, the levels of contact forces, as well as torsional moments are determined by the BMI and influence the femoral stem during daily activities [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, body weight over 75 kg was seen to have a significant impact on subsidence of the Vision 2000 stem (DePuy, Warsaw, IN, USA) as observed by Stihsen et al, whereas a BMI > 30 kg/m 2 had no influence [ 16 ]. In contrast, the findings of Akram et al showed increased BMI to be independently associated with an increased risk for subsidence of a trabecular metal taper femoral prosthesis, for which reason the authors recommended caution in utilizing this stem in obese patients [ 22 ]. In the study by Grant et al, a significant increase in subsidence was noted for fit-and-fill stems with increasing BMI ( p = 0.001), while this relationship was not found for tapered wedge design stems ( p = 0.013) [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…The extent of stem subsidence may furthermore be contributed by patient demographics and surgical factors, including BMI, as well as the fit and fill of the stem in relation to the particular femoral configuration [ 15 ]. However, available studies that yielded different results depending on the investigated implant have been presented in the past [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Mid-Term Migration Behavior of an Uncemented Proximally Anchored Straight Stem—A Retrospective EBRA Migration Analysis

Blum,

Neugebauer,

Keiler

et al. 2023

JCM

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Background: Aseptic loosening is one of the most-common causes of the failure of cementless stems. Einzel Bild Röntgen Analyse-Femoral Component Analysis (EBRA-FCA) allows the diagnosis of stem migration, which can be considered a factor in predicting implant survival. The current study aimed to present the migration behavior of a tapered proximally anchored straight stem. Methods: This retrospective study reviewed all consecutive patients who received a cementless CBC straight stem (Mathys AG, Bettlach, Switzerland) between 2005 and 2019. We analyzed the migration pattern using the EBRA-FCA software and reviewed their medical histories. In addition, periprosthetic radiolucency was rated according to the Gruen zones and femoral configuration according to Dorr. Results: A total of 333 stems in 332 patients (female 191; male 141) met our inclusion criteria. The mean age at surgery was 63 (range 21–87) years. Migration analysis by EBRA-FCA showed a mean subsidence of 1.6 mm at final follow-up at 96 months with a maximum noted mean subsidence of 2.0 mm at 72 and 84 months. Dorr Type A showed a tendency of less subsidence than did Dorr Type B and was statistically significant at 6 (p = 0.0396) and 72 months (p = 0.0127). The body mass index (BMI) and increased subsidence were not found to correlate (p > 0.05). For this cohort, the overall femoral revision-free rate was 95.2% and the revision-free rate for aseptic loosening was 99.1%. Conclusions: The results showed migration behavior in cementless stems with initial increased migration and subsequent secondary stabilization, suggesting an excellent long-term outcome. Stem migration of this tapered proximally anchored stem might be lower in Dorr Type A than in Dorr Type B femurs without being statistically significant at all time points.

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“…Tantalum metal is a highly biocompatible biomaterial applied to joint prostheses 12 – 14 . Porous tantalum is used on the femoral component surface in THA to enhance fixation properties 12 , 13 . Porous tantalum has a three-dimensional structure which is similar to that of cancellous bone 12 .…”

Section: Introductionmentioning

confidence: 99%

Effects of porous tantalum on periprosthetic bone remodeling around metaphyseal filling femoral stem: a multicenter, prospective, randomized controlled study

Motomura

Mashima

Imai

et al. 2022

Sci Rep

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Periprosthetic bone loss due to adaptive bone remodeling is an important unresolved issue in cementless total hip arthroplasty (THA). The use of porous tantalum on the proximal surface of the femoral stem is expected to decrease postoperative bone loss around the prosthesis through early fixation. We conducted a multicenter randomized controlled study to determine if porous tantalum could reduce periprosthetic bone loss after THA. From October 2012 to September 2014, 118 patients (mean age, 61.5 years; 107 females and 11 males) were prospectively enrolled and were randomly allocated at a ratio of 1:1 to either a metaphyseal filling stem with a proximal porous tantalum coating (Trabecular Metal) or a conventional metaphyseal filling stem with fiber mesh coating (VerSys). Patients underwent dual-energy x-ray absorptiometry scans within 1 week after surgery (baseline) and at 6, 12, and 24 months after surgery to assess periprosthetic bone mineral density (BMD) in the 7 Gruen zones. In addition, the Japanese Orthopaedic Association hip score was assessed before surgery and at 6, 12, and 24 months after surgery. In the proximal periprosthetic region (zones 1 and 7), the Trabecular Metal group had significantly smaller reductions in BMD than the VerSys group throughout the study period. In the VerSys group, significant reductions in BMD compared to baseline were seen at each measurement point in all regions, except in zone 6 at 24 months. In the Trabecular Metal group, no significant reductions in BMD relative to baseline were seen in zones 1, 5, or 6 throughout the study period. Both groups demonstrated similar improvement in Japanese Orthopaedic Association hip scores over the study period. This study demonstrated that a proximally coated stem with porous tantalum has superior results over a conventional stem with titanium fiber mesh in terms of periprosthetic bone remodeling.

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Mid-Term Survivorship, Performance, and Predictors of Outcome in Primary Total Hip Arthroplasty With a Porous Tantalum Femoral Prosthesis

Cited by 6 publications

References 19 publications

Improving osteoinduction and osteogenesis of Ti6Al4V alloy porous scaffold by regulating the pore structure

Improving osteoinduction and osteogenesis of Ti6Al4V alloy porous scaffold by regulating the pore structure

Mid-Term Migration Behavior of an Uncemented Proximally Anchored Straight Stem—A Retrospective EBRA Migration Analysis

Effects of porous tantalum on periprosthetic bone remodeling around metaphyseal filling femoral stem: a multicenter, prospective, randomized controlled study

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