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. 2022 Jun 20;57(5):734-740.
doi: 10.1055/s-0041-1739465. eCollection 2022 Oct.

Midterm Radiographic Results and Reoperations of Tantalum Trabecular Metal Cones in Knee Arthroplasties

Sandra Tie Nishibe Minamoto  1 , Luís Felipe Tupinambá da Silva  1 , José Leonardo Rocha de Faria  1 , Hugo Alexandre de Araujo Barros Cobra  1 , Idemar Monteiro da Palma  2 , Alan de Paula Mozella  1
Affiliations

Midterm Radiographic Results and Reoperations of Tantalum Trabecular Metal Cones in Knee Arthroplasties

Sandra Tie Nishibe Minamoto et al. Rev Bras Ortop (Sao Paulo). .

Abstract

Objective The management of bone loss represents a challenge in revisions of total knee arthroplasty (rTKA) and in complex primary total knee arthroplasties (TKAs). The purpose of the present study was to evaluate the midterm outcomes (5-year minimum follow-up) of knee reconstructions with tantalum trabecular metal (TM) cones on bone defects Anderson Orthopaedics Research Institute (AORI) 2 and 3. Materials and Methods A retrospective analysis of the medical records of patients operated on between July 2008 and November 2014 was performed, collecting the following data: age, gender, laterality, body mass index, etiology of arthrosis, comorbidities, AORI classification of bone defects, causes for revision, readmissions, reoperations, perioperative and postoperative complications, radiographic signs of osteointegration, and maintenance of the TM support. Results A total of 11 patients with a mean follow-up of 7.28 years (standard deviation [SD] = 1.88; range = 5.12-10 years) was evaluated, with 1 patient operated upon for a primary arthroplasty, 6 for revision arthroplasties, and 4 for a second revision arthroplasty (re-revision). There were complications with the surgical wound, injury to the extensor mechanism and loosening of the femoral component in three of the patients that led to the necessity of four procedures due to complications with the surgical wound, injury to the extensor mechanism and loosening of the femoral component. Radiological signs of osteointegration of the trabecular cones were observed in all patients. We did not observe migration of the TM cones or the prosthetic components in the sample. Conclusion The tantalum metaphyseal cones were able to provide efficient structural support to prosthetic implants with radiographic signs of osteointegration in the medium term.

Keywords: arthroplasty, replacement, knee; biocompatible materials; knee prosthesis; osteointegration.

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Conflict of interest statement

Conflito de Interesses Os autores declaram não haver conflito de interesses.

Figures

Fig. 1
Fig. 1
Number of surgeries and exclusion reasons.
Fig. 2
Fig. 2
(A and B) Radiographs in anteroposterior and aseptic loosening profile of the femoral component; (C) intraoperative aspect of bone loss; (D) implanted trabecular metal femoral cone; (E and F) postoperative X-rays.
Fig. 3
Fig. 3
Distribution of causes of total knee arthroplasty failure that required tantalum metaphysary cones to treat bone defect.
Fig. 4
Fig. 4
(A and B) Preoperative radiographs demonstrating failure of knee prosthesis with medial tibial defect due to sinking of the component; (C and D) postoperative radiographs demonstrating treatment of bone defect with tibial metaphysary cone.
Fig. 5
Fig. 5
Evolution and complications of patients submitted to surgery using trabecular metal cones.
Fig. 1
Fig. 1
Número de cirurgias e motivos de exclusão.
Fig. 2
Fig. 2
(A e B) Radiografias em anteroposterior e perfil de soltura asséptica do componente femoral; (C) aspecto intraoperatório da perda óssea; (D) cone femoral de metal trabecular implantado; (E e F) radiografias pós-operatórias.
Fig. 3
Fig. 3
Distribuição das causas de falha da artroplastia total de joelho que necessitaram cones metafisários de tântalo para tratamento do defeito ósseo.
Fig. 4
Fig. 4
(A e B) Radiografias pré-operatórias demonstrando falha de prótese do joelho com defeito tibial medial devido a afundamento do componente; (C e D) radiografias pós-operatórias demonstrando tratamento do defeito ósseo com cone metafisário tibial.
Fig. 5
Fig. 5
Evolução e complicações dos pacientes submetidos a cirurgia com utilização de cones de metal trabecular.
See this image and copyright information in PMC

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