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

Abstract

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.

3D-Printed Porous Tantalum Scaffold Improves Muscle Attachment via Integrin-β1-Activated AKT/MAPK Signaling Pathway

“…Although muscle could attach to the porous Ti alloy scaffold in our previous study, the avulsion force between the muscle and scaffold was only 44% of the normal musculoskeletal connection in a goat TMJ replacement model. This was consistent with the report of Inoue et al Although some literatures pointed out that retaining the bone with muscle attachment and put them into the prosthesis could preserve the normal musculoskeletal structure, the ectopic bone was formed around the prosthesis which limited the joint movement.…”

“…To solve this problem, we constructed a porous Ta scaffold by 3D printing, which not only reduced the weight but also improved the corrosion resistance of the metal. 15 Furthermore, the manufactured porous Ta scaffold has a wider controllable range of porosity and surface roughness and therefore is available to form more complex structures compared with traditional manufacture techniques. 16 However, the ability on the combination of Ta with muscles remains undefined compared with Ti, let alone its relative mechanisms.…”

“…However, Ta also has the disadvantages of high specific gravity, which increased the weight of the implant. To solve this problem, we constructed a porous Ta scaffold by 3D printing, which not only reduced the weight but also improved the corrosion resistance of the metal . Furthermore, the manufactured porous Ta scaffold has a wider controllable range of porosity and surface roughness and therefore is available to form more complex structures compared with traditional manufacture techniques …”

Progress in Montmorillonite Functionalized Artificial Bone Scaffolds: Intercalation and Interlocking, Nanoenhancement, and Controlled Drug Release

“…Commonly used bone scaffold materials include metals [7,8], polymers [9,10], bioceramics/glass [11,12], and their composites [5,13]. Metal materials have excellent mechanical properties and good biocompatibility, while their modulus is much higher than that of natural bone so that it is easy to produce a stress shielding effect, which seriously affects the stability of bone repair [14].…”