Reconstruction of Large Acetabular Defects Using Trabecular Metal Augments

Hasart, Olaf; Perka, Carsten; Lehnigk, Rex; Tohtz, Stephan

doi:10.1007/s00064-010-8026-9

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…Grappiolo et al 4 reported a Harris Hip Score of 40 preoperatively, vs. 90.5 postoperatively. Hasart et al 34 assessed only patients with Paprosky 3A and 3B defects, using the evaluation criteria of Merle D’Aubigne and Postel, 8 and reported an improvement from 6 to 13 points in the postoperative period. Similar increments to those found in the literature were observed in the present patients, with a preoperative mean of 6.67 vs. 4.83 in the postoperative period; the best parameter was improvement of pain.…”

Section: Discussionmentioning

confidence: 99%

Radiographic evaluation of 19 patients with Paprosky 3A and 3B submitted to acetabular review with trabecular metal wedge

Neto¹,

Lima²,

Rabello³

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveThis study is aimed at evaluating the fixation of trabecular metal wedges in patients who underwent revision of total hip arthroplasty with large acetabular bone defects.MethodsThe radiographs of 19 patients (21 hips), who underwent revision of total hip arthroplasty using trabecular metal wedges from September 2010 to December 2014 were evaluated. This study included only cases of Paprosky 3A and 3B. Preoperative and postoperative images were analyzed. Non-fixation of the implant was defined by the presence of angular variation of the component higher 10 degrees or displacement greater than 6 mm. Patients with follow-up times of less than 24 months or who did not attend the last two appointments were excluded from the study.ResultsThe mean follow-up time was 39.4 months (25–61). Fixation was achieved in all cases despite its complexity. There was only one case of dislocation that was treated with open reduction. One case developed infection, and was surgically approached on two occasions, with extensive debridement and intravenous antibiotics following protocol, with good evolution.ConclusionThe implanted trabecular metal wedges showed excellent results in the short- and medium-term and may represent another option in the reconstruction of large acetabular defects, sometimes replacing bone reconstruction that uses bone tissue banks or autologous graft.

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Section: Discussionmentioning

confidence: 99%

Radiographic evaluation of 19 patients with Paprosky 3A and 3B submitted to acetabular review with trabecular metal wedge

Neto¹,

Lima²,

Rabello³

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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show abstract

“…In our study, the mean correction was 17 mm. Hasart et al 26 reported that there was an improvement in the center of rotation of the hip from 35 mm (range: 16–55 mm) to 14 mm (range: 5–27). Siegmeth et al 27 reported that there was an improvement in the center of rotation from 50 mm to 28 mm.…”

Section: Discussionmentioning

confidence: 99%

“…Borland et al 25 reported a wedge incorporation rate of 100% among 24 cases over a five-year period. Among 38 patients with type IIIA and IIIB defects who were followed up for 25 months, Hasart et al 26 reported that two cases required revision due to loosening or migration. In 34 patients with defects ranging from type IIA to type IIIB who were followed up for 24 months, Siegmeth et al 27 reported survival of 94.11%.…”

Section: Discussionmentioning

confidence: 99%

“…In 37 patients, Del Gaizo et al 22 reported that there was an improvement in the Harris Hip Score from 33.0 to 81.5 points. Among 38 patients with type IIIA and IIIB defects who were followed up for 25 months, Hasart et al 26 observed that the Merle d’Aubigné functional score increased from 6 to 13 points and the Harris Hip Score from 29 to 79 points.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the fixation of the trabecular metal wedge in patients undergoing revision of total hip arthroplasty

Callado

Kimura

Leal

et al. 2014

Revista Brasileira de Ortopedia (English Edition)

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Objectivethis study aimed to evaluate the fixation of the trabecular metal wedge in patients undergoing revision of total hip arthroplasty.Methodstwenty-three cases with minimum grading of Paprosky II-B that were operated between July 2008 and February 2013 were evaluated. These cases were evaluated based on radiographs before the operation, immediately after the operation and later on after the operation. Loss of fixation was defined as a change in the abduction angle of the component greater than 10° or any mobilization greater than 6 mm.Resultsit was found that there was 100% fixation of the acetabula after a mean of 29.5 months. One case underwent removal of the implanted components due to infection.Conclusionsthere is still no consensus regarding the best option for reconstructing hips with bone loss. However, revision using a trabecular metal wedge has presented excellent short- and medium-term results. This qualifies it as an important tool for achieving a fixed and stable acetabular component.

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“…Nowadays, porous titanium and its alloys are commonly used for clinical applications under loading conditions because one can adjust their porosity and mechanical features in order to mimic the bone properties for each site of implantation. This enables its use for orthopedic applications, such as fixation screws, spinal fixation devices, artificial ligament anchors, dental implants, and foot and ankle reconstructive wedges [19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

On-Growth and In-Growth Osseointegration Enhancement in PM Porous Ti-Scaffolds by Two Different Bioactivation Strategies: Alkali Thermochemical Treatment and RGD Peptide Coating

Rappe

Ortiz-Hernández

Punset

et al. 2022

IJMS

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A lack of primary stability and osteointegration in metallic implants may result in implant loosening and failure. Adding porosity to metallic implants reduces the stress shielding effect and improves implant performance, allowing the surrounding bone tissue to grow into the scaffold. However, a bioactive surface is needed to stimulate implant osteointegration and improve mechanical stability. In this study, porous titanium implants were produced via powder sintering to create different porous diameters and open interconnectivity. Two strategies were used to generate a bioactive surface on the metallic foams: (1) an inorganic alkali thermochemical treatment, (2) grafting a cell adhesive tripeptide (RGD). RGD peptides exhibit an affinity for integrins expressed by osteoblasts, and have been reported to improve osteoblast adhesion, whereas the thermochemical treatment is known to improve titanium implant osseointegration upon implantation. Bioactivated scaffolds and control samples were implanted into the tibiae of rabbits to analyze the effect of these two strategies in vivo regarding bone tissue regeneration through interconnected porosity. Histomorphometric evaluation was performed at 4 and 12 weeks after implantation. Bone-to-implant contact (BIC) and bone in-growth and on-growth were evaluated in different regions of interest (ROIs) inside and outside the implant. The results of this study show that after a long-term postoperative period, the RGD-coated samples presented higher quantification values of quantified newly formed bone tissue in the implant’s outer area. However, the total analyzed bone in-growth was observed to be slightly greater in the scaffolds treated with alkali thermochemical treatment. These results suggest that both strategies contribute to enhancing porous metallic implant stability and osteointegration, and a combination of both strategies might be worth pursuing.

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Reconstruction of Large Acetabular Defects Using Trabecular Metal Augments

Cited by 13 publications

References 21 publications

Radiographic evaluation of 19 patients with Paprosky 3A and 3B submitted to acetabular review with trabecular metal wedge

Radiographic evaluation of 19 patients with Paprosky 3A and 3B submitted to acetabular review with trabecular metal wedge

Evaluation of the fixation of the trabecular metal wedge in patients undergoing revision of total hip arthroplasty

On-Growth and In-Growth Osseointegration Enhancement in PM Porous Ti-Scaffolds by Two Different Bioactivation Strategies: Alkali Thermochemical Treatment and RGD Peptide Coating

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