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.
Highlights
Osteointegration in orthopedic implants can be compared to bone healing in fractures
Revision Total Knee or Hip Arthroplasty is challenging procedures for surgeons usually characterized by bone loss
Trabecular metal has been proposed in revision Total Knee Arthroplasty (TKA), being considered a viable option to treat severe type 2 or 3 defects
Summary
Osteointegration in orthopedic implants can be compared to bone healing in fractures. The limits for implant integration have been established in some studies [2, 3] showing bone ingrowth for movements smaller than 50 microns, pseudoligamentous healing from 50 to 150 microns, and pseudocapsule formation for movements bigger than 150 microns. A small mechanical stimulation at the interface can enhance implant healing in the first phase after surgery Another important aspect in implant integration is pore size; recent studies by Bobyn and associates [3] showed the relationship between pore size and bone ingrowth rate. This may be related to different microenvironments present within different sizes pores and their effect on osteogenesis [4]. The excellent resistance to erosion-corrosion and high frictional characteristics associated with its bioactivity make tantalum a promising material for orthopedic implants
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