Advertisement

Trabecular Metal Augments

  • Eustathios Kenanidis
  • Ioannis Nakopoulos
  • Eleftherios Tsiridis
  • Pedro Dantas
  • Vasco V. Mascarenhas
  • Sérgio Gonçalves
  • Michael J. Feldstein
  • Matthew S. Austin
  • William J. Hozack
  • William L. Griffin
  • Savyasachi C. Thakkar
  • James D. Slover
  • Julie Shaner
  • Javad Parvizi
Chapter

Abstract

Porous trabecular metal augments are uncemented hemispheric or elliptical components for the management of severe acetabular bone loss [1]. Based on the unique characteristics of trabecular metal, they can be used instead of structural allograft to reconstruct major acetabular bone defects [1]. They are made of porous metal tantalum or titanium alloys, and they are available in different shapes and sizes [2]. The basic shapes include the half-moon augments appropriate for minor column defects and the buttress augments with anterior of posterior columnar extensions to compensate for anterosuperior or posterosuperior acetabular defects [1, 3]. For superior segmental defects more than 30 mm above the acetabulum, a figure of seven augments may also be used [1].

References

  1. 1.
    Abolghasemian M, Tangsataporn S, Sternheim A, Backstein D, Safir O, Gross AE. Combined trabecular metal acetabular shell and augment for acetabular revision with substantial bone loss: a mid-term review. Bone Joint J. 2013;95-B:166–72.CrossRefPubMedGoogle Scholar
  2. 2.
    Teeter MG, Naudie DDR, Howard JL, McCalden RW, MacDonald SJ. Do revision total hip augments provide appropriate modularity? Can J Surg. 2015;58(1):54–7.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Nehme A, Lewallen DG, Hanssen AD. Modular porous metal augments for treatment of severe acetabular bone loss during revision hip arthroplasty. Clin Orthop Relat Res. 2004;429:201–8.CrossRefGoogle Scholar
  4. 4.
    Issack PS. Current concepts review use of porous tantalum for acetabular reconstruction in revision hip arthroplasty. J Bone Joint Surg Am. 2013;95:1981–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Sporer SM, Bottros JJ, Hulst JB, et al. Acetabular distraction: an alternative for severe defects with chronic pelvic discontinuity. Clin Orthop Relat Res. 2012;470:3156–63.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Brown NM. The revision hip arthroplasty acetabular distraction an alternative approach to pelvic discontinuity in failed total hip replacement. Bone Joint J. 2014;96-B(11 Suppl A):73–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Sheth NP. Management factorials in total hip arthroplasty acetabular distraction an alternative for severe acetabular bone loss and chronic pelvic discontinuity. Bone Joint J. 2014;96-B(11 Suppl A):36–42.CrossRefPubMedGoogle Scholar
  8. 8.
    Ballester Alfaro JJ, Sueiro Fernandez J. Trabecular metal buttress augment and the trabecular metal cup-cage construct in revision hip arthroplasty for severe acetabular bone loss and pelvic discontinuity. Hip Int. 2010;20(S7):119–27.CrossRefGoogle Scholar
  9. 9.
    Steven Borland W, et al. Use of porous trabecular metal augments with impaction bone grafting in management of acetabular bone loss early to medium-term results. Acta Orthop. 2012;83(4):347–52.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Weeden SH. The use of tantalum porous metal implants for Paprosky 3A and 3B defects. J Arthroplast. 2007;22(6 Suppl. 2):151–5.CrossRefGoogle Scholar
  11. 11.
    Del Gaizo DJ. Tantalum augments for Paprosky IIIA defects remain stable at midterm follow up. Clin Orthop Relat Res. 2012;470:395–401.CrossRefPubMedGoogle Scholar
  12. 12.
    Whitehouse MR. Continued good results with modular trabecular metal augments for Acetabular defects in hip Arthroplasty at 7 to 11 years. Clin Orthop Relat Res. 2015;473:521–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Fernandez-Fairen M, Murcia A, Blanco A, Merono A, Murcia A Jr, Ballester J. Revision of failed total hip arthroplasty acetabular cups to porous tantalum components: a 5-year follow-up study. J Arthroplast. 2010;25(6):865–72.CrossRefGoogle Scholar
  14. 14.
    Grappiolo G, Loppini M, Longo UG, Traverso F, Mazziotta G, Denaro V. Trabecular metal augments for the Management of Paprosky Type III defects without pelvic discontinuity. J Arthroplast. 2015;30:1024–9.CrossRefGoogle Scholar
  15. 15.
    Lingaraj K. The management of severe acetabular bone defects in revision hip arthroplasty using modular porous metal components. J Bone Joint Surg (Br). 2009;91-B:1555–60.CrossRefGoogle Scholar
  16. 16.
    Cohen R. A porous tantalum trabecular metal: basic science. Am J Orthop. 2002;31:216–7.PubMedGoogle Scholar
  17. 17.
    Flecher X, Paproskyb W, Grillo JC, Aubaniaca JM, Argensona JN. Do tantalum components provide adequate primary fixation in all acetabular revisions? Orthop Traumatol Surg Res. 2010;96:235–41.CrossRefPubMedGoogle Scholar
  18. 18.
    Levine B, la Valle CJ, Jacobs JJ. Applications of porous tantalum in total hip arthroplasty. J Am Acad Orthop Surg. 2006;14:646.CrossRefPubMedGoogle Scholar
  19. 19.
    Meneghini RM, Meyer C, Buckley CA, et al. Mechanical stability of novel highly porous metal acetabular components in revision total hip arthroplasty. J Arthroplast. 2010;25:337.CrossRefGoogle Scholar
  20. 20.
    Christie MJ. Clinical applications of trabecular metal. Am J Orthop. 2002;31:219–20.PubMedGoogle Scholar
  21. 21.
    Bobyn JD, Pilliar RM, Cameron HU, Weatherly GC, Kent GM. The effect of porous surface configuration on the tensile strength of fixation of implants by bone ingrowth. Clin Orthop Relat Res. 1980;149:291–8.Google Scholar
  22. 22.
    Bobyn JD, Poggie RA, Krygier JJ, Lewallen DG, Hanssen AD, Lewis RJ, Unger AS, O’Keefe TJ, Christie MJ, Nasser S, Wood JE, Stulberg SD, Tanzer M. Clinical validation of a structural porous tantalum biomaterial for adult reconstruction. J Bone Joint Surg Am. 2004;86(Suppl 2):123–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Bobyn JD, Stackpool GJ, Hacking SA, Tanzer M, Krygier JJ. Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial. J Bone Joint Surg (Br). 1999;81-B:907–14.CrossRefGoogle Scholar
  24. 24.
    Hacking SA, et al. Fibrous tissue ingrowth and attachment to porous tantalum. J Biomed Mater Res. 2000;52:631.CrossRefPubMedGoogle Scholar
  25. 25.
    Van Kleunen JP, Lee GC, Lementowski PW, Nelson CL, Garino JP. Acetabular revisions using trabecular metal cups and augments. J Arthroplast. 2009;24(6 suppl):64–8.CrossRefGoogle Scholar
  26. 26.
    Moličnik A. Porous tantalum shells and augments for acetabular cup revisions. Eur J Orthop Surg Traumatol. 2014;24:911–7.CrossRefGoogle Scholar
  27. 27.
    Siegmeth A, Duncan CP, Masri BA, Kim WY, Garbuz DS. Modular tantalum augments for acetabular defects in revision hip arthroplasty. Clin Orthop Relat Res. 2009;467:199–205.CrossRefPubMedGoogle Scholar
  28. 28.
    Sporer SM, Paprosky WG. The use of a trabecular metal acetabular component and trabecular metal augment for severe acetabular defects. J Arthroplast. 2006;21(6 suppl 2):83–6.CrossRefGoogle Scholar
  29. 29.
    Sporer SM, Paprosky WG. Acetabular revision using a trabecular metal acetabular component for severe acetabular bone loss associated with a pelvic discontinuity. J Arthroplast. 2006;21(6 suppl 2):87–90.CrossRefGoogle Scholar
  30. 30.
    Park DK, Della Valle CJ, Quigley L, Moric M, Rosenberg AG, Galante JO. Revision of the acetabular component without cement. A concise follow-up, at twenty to twenty-four years, of a previous report. J Bone Joint Surg Am. 2009;91(2):350–5.CrossRefPubMedGoogle Scholar
  31. 31.
    Camacho A, Pinto F, Almeida R, Dantas P, Amaral L. Resultados da utilização de implantes de tântalo poroso em cirurgia de revisão acetabular. Rev Port Ortop Traum. 2013;21(1):17–25.Google Scholar
  32. 32.
    von Roth P, Abdel MP, Harmsen WS, Berry DJ. Uncemented jumbo cups for revision total hip arthroplasty: a concise follow-up, at a mean of twenty years, of a previous report. J Bone Jt Surg. 2015;97:284–7. doi: 10.2106/JBJS.N.00798.CrossRefGoogle Scholar
  33. 33.
    Chen AF, Hozack WJ. Component selection in revision total hip Arthroplasty. Orthop Clin North Am. 2014;45:275–86. doi: 10.1016/j.ocl.2014.03.001.CrossRefPubMedGoogle Scholar
  34. 34.
    Sheth NP, Nelson CL, Springer BD, Fehring TK, Paprosky WG. Acetabular bone loss in revision total hip arthroplasty: evaluation and management. J Am Acad Orthop Surg. 2013;21:128–39. doi: 10.5435/JAAOS-21-03-128.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Klatte TO, Kendoff D, Sabihi R, Kamath AF, Rueger JM, Gehrke T. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study. J Arthroplasty. 2014;29(7):1443–8.CrossRefPubMedGoogle Scholar
  36. 36.
    Restrepo C, Mashadi M, Parvizi J, Austin MS, Hozack W. Modular femoral stems for revision total hip arthroplasty. Clin Orthop Relat Res. 2011;469(2):476–82.CrossRefPubMedGoogle Scholar
  37. 37.
    Dahl B, McNeely C, Robinson BS, Maloney WJ, Paprosky WG, Ries MD, Saleh KJ. Acetabular reconstruction in revision total hip arthroplasty: maximizing function and outcomes in protrusio and cavitary defects. Instr Course Lect. 2014;63:219–25.PubMedGoogle Scholar
  38. 38.
    Pope D, Blankenship S, Jones G, Robinson BS, Maloney WJ, Paprosky WG, Ries MD, Saleh KJ. Maximizing function and outcomes in acetabular reconstruction: segmental bony defects and pelvic discontinuity. Instrc Course Lect. 2014;63:187–97.Google Scholar
  39. 39.
    Long WJ, Noiseux NO, Mabry TM, Hanssen AD, Lewallen DG. Uncemented porous tantalum acetabular components: early follow-up and failures in 599 revision total hip arthroplasties. Iowa Ortho J. 2015;35:108–13.Google Scholar
  40. 40.
    Deirmengian GK, Zmistowski B, O’Neil JT, Hozack WJ. Management of acetabular bone loss in revision total hip arthroplasty. JBJS Am. 2011;93(19):1842–52.CrossRefPubMedGoogle Scholar
  41. 41.
    Tokarski AT, Novack TA, Parvizi J. Is tantalum protective against infection in revision total hip arthroplasty? Bone Joint J. 2015;97-B(1):45–9.CrossRefPubMedGoogle Scholar
  42. 42.
    Jafari SM, Bender B, Coyle C, Parvizi J, Sharkey PF, Hozack WJ. Do tantalum and titanium cups show similar results in revision hip arthroplasty? Clin Orthop Relat Res. 2010;468(2):459–65.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Eustathios Kenanidis
    • 1
  • Ioannis Nakopoulos
    • 1
  • Eleftherios Tsiridis
    • 2
  • Pedro Dantas
    • 3
  • Vasco V. Mascarenhas
    • 4
  • Sérgio Gonçalves
    • 3
  • Michael J. Feldstein
    • 5
  • Matthew S. Austin
    • 6
  • William J. Hozack
    • 7
  • William L. Griffin
    • 8
    • 9
  • Savyasachi C. Thakkar
    • 10
  • James D. Slover
    • 11
  • Julie Shaner
    • 12
  • Javad Parvizi
    • 13
    • 14
  1. 1.Academic Orthopaedic UnitAristotle University Medical SchoolThessalonikiGreece
  2. 2.Academic Orthopaedic UnitPapageorgiou General Hospital, Aristotle University Medical SchoolThessalonikiGreece
  3. 3.Hospital Curry CabralLisbonPortugal
  4. 4.UIME (MSK Imaging Unit), Hospital da LuzLisbonPortugal
  5. 5.Kaiser PermananteOakland,USA
  6. 6.Rothman Institute OrthopaedicsPhiladelphiaUSA
  7. 7.Sidney Kimmel Medical School at Thomas Jefferson University, Rothman Institute OrthopaedicsPhiladelphiaUSA
  8. 8.OrthoCarolina Research InstituteCharlotteUSA
  9. 9.OrthoCarolina Hip and Knee CenterCharlotteUSA
  10. 10.Department of Adult Hip & Knee Reconstruction SurgeryMedStar Georgetown University Hospital and MedStar Washington Hospital CenterWashington, DCUSA
  11. 11.Department of Adult Hip & Knee Reconstruction SurgeryNew York University Hospital for Joint DiseasesNew YorkUSA
  12. 12.Temple University HospitalPhiladelphiaUSA
  13. 13.Sidney Kimmel School of MedicinePhiladelphiaUSA
  14. 14.Rothman Institute at Thomas Jefferson UniversityPhiladelphiaUSA

Personalised recommendations