AIMS: Metaphyseal cones and sleeves are components used in revision knee arthroplasty to ensure load transfer, encourage bone on-growth and prevent stress shielding. Additive manufacturing of titanium alloy implants is a novel technique with limited clinical outcome reports in the literature. The aim of this study was to determine radiographic evidence of osseointegration and early results of a single manufacturer porous titanium metaphyseal components in the proximal tibia. METHODS: We retrospectively reviewed the prospectively collected database of two institutions. Patients who underwent revision knee arthroplasty using porous titanium components by a single manufacturer were identified. Immediate post-operative and latest follow-up radiographs were independently analysed by 2 reviewers to determine metaphyseal bone contact and level of osseointegration in relevant Knee Society Radiographic Evaluation and Scoring System zones. RESULTS: 22 patients (15 males; 7 females) with a mean age of 71 (49-92) years were included. The mean follow-up period was 14 months (2-44 months). Cones were used in 16 patients and sleeves in 6. Interobserver reliability assessment showed substantial agreement (weighted Kappa 0.71, (95% CI: 0.60, 0.81). There was significant correlation between the bone contact in the immediate postop radiograph and osseointegration at final follow-up (kendall's tau-b: 0.698, p < 0.001). Infection free prosthetic joint survival was 20/22 at final follow-up. CONCLUSION: Porous titanium metaphyseal components produced with additive manufacturing provided excellent osseointegration and no early clinical failures. Partial or complete contact of the cone with native bone in the immediate postoperative radiograph resulted in osseointegration in all cases.
AIMS: Metaphyseal cones and sleeves are components used in revision knee arthroplasty to ensure load transfer, encourage bone on-growth and prevent stress shielding. Additive manufacturing of titanium alloy implants is a novel technique with limited clinical outcome reports in the literature. The aim of this study was to determine radiographic evidence of osseointegration and early results of a single manufacturer porous titanium metaphyseal components in the proximal tibia. METHODS: We retrospectively reviewed the prospectively collected database of two institutions. Patients who underwent revision knee arthroplasty using porous titanium components by a single manufacturer were identified. Immediate post-operative and latest follow-up radiographs were independently analysed by 2 reviewers to determine metaphyseal bone contact and level of osseointegration in relevant Knee Society Radiographic Evaluation and Scoring System zones. RESULTS: 22 patients (15 males; 7 females) with a mean age of 71 (49-92) years were included. The mean follow-up period was 14 months (2-44 months). Cones were used in 16 patients and sleeves in 6. Interobserver reliability assessment showed substantial agreement (weighted Kappa 0.71, (95% CI: 0.60, 0.81). There was significant correlation between the bone contact in the immediate postop radiograph and osseointegration at final follow-up (kendall's tau-b: 0.698, p < 0.001). Infection free prosthetic joint survival was 20/22 at final follow-up. CONCLUSION: Porous titanium metaphyseal components produced with additive manufacturing provided excellent osseointegration and no early clinical failures. Partial or complete contact of the cone with native bone in the immediate postoperative radiograph resulted in osseointegration in all cases.
Authors: Elke Jeschke; Mustafa Citak; Christian Günster; Andreas Matthias Halder; Karl-Dieter Heller; Jürgen Malzahn; Fritz Uwe Niethard; Peter Schräder; Josef Zacher; Thorsten Gehrke Journal: Clin Orthop Relat Res Date: 2017-08-11 Impact factor: 4.176
Authors: Kevin M Denehy; Sarag Abhari; Viktor E Krebs; Carlos A Higuera-Rueda; Linsen T Samuel; Assem A Sultan; Michael A Mont; Arthur L Malkani Journal: J Arthroplasty Date: 2019-03-28 Impact factor: 4.757
Authors: Fabio Mancino; Vincenzo Di Matteo; Fabrizio Mocini; Silvia Pietramala; Alessandro Singlitico; Andrea De Fazio; Vincenzo La Vergata; Giorgio Gasparini; Giulio Maccauro; Ivan De Martino Journal: Orthop Rev (Pavia) Date: 2022-06-27
Authors: Yunong Ao; Lin Guo; Hao Chen; Rui He; Pengfei Yang; Dejie Fu; Lingchuan Gu; Yang Peng; Ran Xiong; Liu Yang; Fuyou Wang Journal: Front Bioeng Biotechnol Date: 2022-09-05