Trabecular Metal Use in Paprosky Type 2 and 3 Acetabular Defects: 5-Year Follow-Up

Ray, Andrew; MacDonald, Deborah J.; Wade, F A; Burnett, Richard T.; Moran, Matthew

doi:10.1016/j.arth.2015.10.033

Cited by 26 publications

(13 citation statements)

References 49 publications

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“…While reconstruction of minor acetabular defects with porous metal components does not appear to be problematic [30], major bone loss leads to much poorer results, requiring revision surgeries [16, 31]. These major defects accounted for 58% of the patients included in the present study group, and this might explain the reduced rate of cup survival.…”

Section: Discussionmentioning

confidence: 99%

A single centre study of 41 cases on the use of porous tantalum metal implants in acetabular revision surgery

Theil

Schmidt-Braekling

Gosheger

et al. 2019

BMC Musculoskelet Disord

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Background This study aims at investigating cup survival of porous tantalum revision cups and identifies risk factors for failure. Methods We retrospectively reviewed 41 patients treated between 2010 and 2012. Main indications were aseptic loosening in 83% and two-stage exchange after periprosthetic joint infection in 17% of cases. Mean follow-up period was 72 months. Femoral megaprostheses were used in 13% of cases. Most defects were classified as Paprosky 3b (29%). Function was assessed using the Harris Hip score. Results Aseptic cup survivorship was 80% at 104 months (95% Confidence Interval 67.4–92.4). Overall implant survival was 73%. Major bone loss defects (Paprosky types 2c to 3b) were associated with a significantly higher rate of failure than minor defects ( P = 0.002). There were eight cases of aseptic loosening (19.5%) and two of infection (4.9%). Previous surgeries, indication for acetabular revision, patient-related risk factors and use of megaprostheses did not significantly influence implant survival. The Harris Hip Score improved from a median of 40 (Interquartile range 31–45) to 82 (interquartile range 65–88) postoperative ( P < 0.0001). Conclusions In summary, the use of porous tantalum metal implants in acetabular revision surgery achieves good to excellent short- term and mid-term functional results and an acceptable complication rate relative to the extent of defect and previous surgery. However, one should be aware of potential limitations of the implants in addressing large defects and discontinuity.

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Section: Discussionmentioning

confidence: 99%

A single centre study of 41 cases on the use of porous tantalum metal implants in acetabular revision surgery

Theil

Schmidt-Braekling

Gosheger

et al. 2019

BMC Musculoskelet Disord

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“…If not treated, it eventually leads to collapse of the femoral head, osteoarthritis, and disability, which require THA. [ 10 ] However, THA prosthesis longevity and other factors are poor. [ 11 ] THA is not recommended for early ONFH, especially in young patients.…”

Section: Discussionmentioning

confidence: 99%

A new 3D printed titanium metal trabecular bone reconstruction system for early osteonecrosis of the femoral head

Zhang

Sun

et al. 2018

Medicine

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Presently, biomechanical support therapy for the femoral head has become an important approach in the treatment of early osteonecrosis of the femoral head (ONFH). Previous studies have reported that the titanium metal trabecular bone reconstruction systems (TMTBRS) achieved satisfactory clinical results for the treatment of early femoral head necrosis. Electron beam melting technology (EBMT) is an important branch of 3D printing technology, which enables the construction of an interface that is required for support of bone in-growth. However, the effect of TMTBRS created using EBMT for clinical applications for early ONFH is still unknown. At present, there are no reports on this topic worldwide. The purpose of this study was to assess the safety of a new 3D printed TMTBRS implant and to evaluate its clinical efficacy in early ONFH.Thirty patients who underwent surgery for ONFH were selected. The stages of ONFH were classified according to the Association Research Circulation Osseus (ARCO) classification. They were followed-up and radiological examination was performed at 6, 12, and 24 months post-surgery to assess TMTBRS stability and bone growth in the bone trabecular holder portion surface. To evaluate hip function, postoperative Harris and Visual Analogue Scale (VAS) scores were used.The postoperative Harris score increased significantly and VAS score decreased significantly at the 12-month follow-up compared to the 24-month follow-up, wherein the Harris score declined slightly and the VAS score was slightly elevated with the aggravation of ONFH. With the passage of time, postoperative improvement rates were 100% for IIA, 70% for IIB, and 0% for IIC. Hip-preserving rates were 100% for IIA, 100% for IIB, and 50% for IIC.The effect of TMTBRS treatment for early ONFH in ARCO IIA and ARCO IIB is satisfactory. However, it is not recommended for a relatively large area of necrosis such as in ARCO IIC.

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“…En 2016, Clement y cols. 15 comunicaron una supervivencia del 92% en 55 revisiones con defectos tipo II y III de Paprosky, 7 con un seguimiento mínimo de cinco años. En una revisión bibliográfica sistemática que incluyó 1541 revisiones con anillos y 1959 revisiones con metal trabecular, Beckmann y cols.…”

Section: Discussionunclassified

“…7 El desarrollo y la utilización del tantalio trabecular 6 con una porosidad del 75-80%, alto coeficiente de fricción y módulos de elasticidad de Young similares al hueso que le confieren un mejor comportamiento osteoconductivo logra mejores resultados a corto y mediano plazo en el tratamiento de estos acetábulos complejos. [8][9][10][11][12][13][14][15][16] El objetivo principal de este estudio es analizar nuestra experiencia con el uso de copas de tantalio trabecular (MT, Zimmer, Warsaw, Indiana, EE. UU.)…”

Section: Introductionunclassified

Uso de copas de tantalio trabecular para la reconstrucción acetabular compleja. Resultados de una serie de 42 casos y un seguimiento promedio de tres años.[Trabecular metal cup outcomes in complex acetabular reconstruction. Review of 42 cases with a 3-year follow-up].

Hoya

Bidolegui

Alonso

et al. 2018

Rev. Asoc. Arg. Ort. y Traumatol

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Introducción: El objetivo de este estudio es analizar nuestros resultados clínico-radiológicos con el uso de copas de tantalio trabecular para la reconstrucción de acetábulos complejos, tanto en cirugías primarias como en revisiones, y com- pararlos con series similares de otros autores. Materiales y Métodos: Se llevó a cabo una revisión retrospectiva de una serie de 42 cirugías (29 revisiones y 13 artro- plastias primarias) en 40 pacientes, entre marzo de 2010 y marzo de 2016. La serie incluyó a 20 mujeres y 20 hombres, con una edad promedio de 60 años (rango 27-93). El seguimiento promedio fue de 37 meses (rango 12-84). Todos los pacientes fueron tratados con el mismo tipo de metal trabecular. Resultados: Al promedio de seguimiento mencionado la supervivencia del componente acetabular fue del 97,6%. Un paciente fue tratado con artroplastia de resección debido a una infección persistente. La tasa de complicaciones totales fue del 12% y el promedio del Harris Hip Score posoperatorio fue de 81,54 (rango 63,25-92,75). Conclusiones: Aunque se necesita un seguimiento más prolongado, el uso de copas de metal trabecular logra resultados prometedores para el tratamiento de acetábulos complejos.

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Trabecular Metal Use in Paprosky Type 2 and 3 Acetabular Defects: 5-Year Follow-Up

Cited by 26 publications

References 49 publications

A single centre study of 41 cases on the use of porous tantalum metal implants in acetabular revision surgery

A single centre study of 41 cases on the use of porous tantalum metal implants in acetabular revision surgery

A new 3D printed titanium metal trabecular bone reconstruction system for early osteonecrosis of the femoral head

Uso de copas de tantalio trabecular para la reconstrucción acetabular compleja. Resultados de una serie de 42 casos y un seguimiento promedio de tres años.[Trabecular metal cup outcomes in complex acetabular reconstruction. Review of 42 cases with a 3-year follow-up].

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