Implantation of a tantalum patella during revision surgery

Abstract

The reconstruction or restoration of afunctioning patella for active extension and flexion by implantation of atantalum patella. In spite of larger osseous defects of the patella, the goal is to achieve sufficient extensor mechanism function. Patients who have such alarge bone defect in the area of the patella that implantation of atraditional patella replacement is not possible. In addition, patients with aperi-implant fracture of the patella can be treated with atantalum patella and additional plate osteosynthesis. Absence of acortical basic structure of the patella. Complete loss of the patella or the extensor mechanism. Periprosthetic infection. The patella is completely excised. Subsequently, the back surface of the patella is milled to anchor the tantalum structure as accurately as possible without cement. This is fixed circularly after desired positioning by means of nonresorbable suture. Finally, the polyethylene back surface replacement is cemented onto the back surface of the tantalum structure. The patients have alimitation of flexion of 0-0-90° at 20 kilogram partial weight bearing for 12weeks after surgery. A total of 10patients who received atantalum patella between 2013 and 2019 were retrospectively included. Atantalum patella was implanted in 9patients with alarge patellar defect. In one case atantalum patella with additional plate osteosynthesis was implanted to treat aperi-implant fracture of the patella. Loosening of the tantalum patella was observed in 1patient, while in another patient postoperative arthrofibrosis was observed. In 2cases apostoperative superficial wound healing disorder was detected. Two patients had apersistent infection with subsequent complete explantation of the prosthesis.