scholarly journals Use of Tantalum Trabecular Metal Cones for Management of Nonunion of the Distal Femur with Segmental Bone Defects: Technique and Case Series

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Alan W Reynolds ◽  
Patricia R Melvin ◽  
Eric J Yakish ◽  
Nicholas Sotereanos ◽  
Gregory T Altman ◽  
...  
Keyword(s):  
Distal Femur ◽  
Case Series ◽  
Bone Defects ◽  
Autologous Bone Graft ◽  
Trabecular Metal ◽  
Non Union ◽  
Segmental Bone ◽  
Keywords Femur ◽  
Segmental Bone Defects

Introduction: Segmental bone loss in the distal femur presents a challenge for reconstruction regardless of etiology. Use of tantalum trabecular metal cones with intramedullary fixation and autologous bone graft may be used as a salvage technique in difficult situations where other options have either been exhausted or are unavailable. Case Report: Surgical planning and technique for this approach to reconstruction are described. A retrospective review of five cases with >1 year of follow-up was performed to provide radiographic and clinical outcomes. All five patients had satisfactory outcomes with clinical union and retention of implants at final follow-up (average >4 years). Conclusions: Use of tantalum metal cones for reconstruction of distal femur nonunion with segmental bone defects can be a successful technique in a complex group of patients. Keywords: Femur, bone defect, non-union, induced membrane, tantalum.

Treatment of Large Segmental Bone Defects with Reamer-Irrigator-Aspirator Bone Graft: Technique and Case Series

2010 ◽  
Vol 41 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Todd A. McCall ◽  
David S. Brokaw ◽  
Bradley A. Jelen ◽  
D. Kevin Scheid ◽  
Angela V. Scharfenberger ◽  
...  
Keyword(s):  
Bone Graft ◽  
Case Series ◽  
Bone Defects ◽  
Segmental Bone ◽  
Segmental Bone Defects

The presence of periosteum is essential for the healing of large diaphyseal segmental bone defects reconstructed with trabecular metal: A study in the femur of goats

2010 ◽  
Vol 92B (1) ◽  
pp. 24-31 ◽  
Author(s):  
Pieter H. J. Bullens ◽  
H. W. Bart Schreuder ◽  
Maarten C. de Waal Malefijt ◽  
Nico Verdonschot ◽  
Pieter Buma
Keyword(s):  
Bone Defects ◽  
Trabecular Metal ◽  
Segmental Bone ◽  
Segmental Bone Defects

scholarly journals Are Trabecular Metal Cones a Valid Option to Treat Metaphyseal Bone Defects in Complex Primary and Revision Knee Arthroplasty?

Joints ◽  
2017 ◽  
Vol 06 (01) ◽  
pp. 058-064 ◽  
Author(s):  
Tommaso Bonanzinga ◽  
Thorsten Gehrke ◽  
Akos Zahar ◽  
Stefano Zaffagnini ◽  
Maurilio Marcacci ◽  
...  
Keyword(s):  
Infection Rate ◽  
Clinical Data ◽  
Knee Arthroplasty ◽  
Case Reports ◽  
Case Series ◽  
Bone Defects ◽  
Trabecular Metal ◽  
Level Of Evidence ◽  
Metaphyseal Bone

Purpose Metaphyseal bone defects are a challenge in complex primary and revision total knee arthroplasty (TKA). Recently, several studies have been published with promising results about the use of Trabecular Metal (TM) cones to address bone defects. The aim of this study is to review the literature to assess the efficacy of TM cones to address metaphyseal bone loss. Methods A comprehensive search was performed on PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the following keywords: “metaphyseal,” “cones,” “tantalum,” “knee,” and “revision.” Only papers reporting clinical data about the use of trabecular metal cones were included in the analysis. In vitro studies, case reports, surgical technique, or other studies where it was not possible to collect clinical data were excluded. Patients characteristics, details of the surgical procedures, outcome, and complications were collected from each included study. Results No controlled studies were available in the literature and all the papers were case series. In 16 studies included, the records of 442 patients with 447 implants and 523 TM cones were reported. The mean follow-up was 42 months (range: 5–105) for 360 procedures. Among 437 procedures, 30.4% were septic revisions. The Anderson Orthopaedic Research Institute (AORI) classification was available for 352 defects: 13 type 1, 69 type 2A, 115 type 2B, and 155 type 3. To manage these 352 defects, 360 TM cones were implanted. Intraoperative fractures occurred 13 times (10 femoral/3 tibial), 6 required surgical fixation. The overall infection rate was 7.38%, and the infection rate for the aseptic procedures was 0.99%. An aseptic exchange was performed 13 times, among these procedures two TM cones were loose. Signs of loosening were found just in 1.3% of the 523 TM cones implanted (5 femoral/2 tibial) during 447 procedures. Conclusion The TM cones are an effective solution to manage bone defects in complex primary and revision TKA at intermediate follow-up. The incidence of complications was low; however, the femoral metaphysis proved to be more susceptible to complications. Level of Evidence Level IV, systematic review of level IV studies.

Characterization of Tissue-Engineered Human Periosteum and Allograft Bone Constructs: The Potential of Periosteum in Bone Regenerative Medicine

2020 ◽  
Vol 209 (2–3) ◽  
pp. 128-143
Author(s):  
Qing Yu ◽  
Robin DiFeo Jacquet ◽  
William J. Landis
Keyword(s):  
Gene Expression ◽  
Tissue Engineering ◽  
Regenerative Medicine ◽  
Bone Formation ◽  
Bone Defects ◽  
Delayed Union ◽  
Non Union ◽  
Segmental Bone ◽  
First Time ◽  
Segmental Bone Defects

Delayed-union or non-union between a host bone and a graft is problematic in clinical treatment of segmental bone defects in orthopedic cases. Based on a preliminary study of human periosteum allografts from this laboratory, the present work has extensively investigated the use of human cadaveric tissue-engineered periosteum-allograft constructs as an approach to healing such serious orthopedic surgical situations. In this current report, human cadaveric periosteum-wrapped bone allografts and counterpart controls without periosteum were implanted subcutaneously in athymic mice (<i>nu/nu</i>) for 10, 20, and, for the first time, 40 weeks. Specimens were then harvested and assessed by histological and gene expression analyses. Compared to controls, the presence of new bone formation and resorption in periosteum-allograft constructs was indicated in both histology and gene expression results over 40 weeks of implantation. Of several genes also examined for the first time, <i>RANKL</i> and <i>SOST</i> expression levels increased in a statistically significant manner, data suggesting that bone formation and the presence of increasing numbers of osteocytes in bone matrices had increased with time. The tissue-engineering strategy described in this study provides a possible means of improving delayed-union or non-union at the healing sites of segmental bone defects or bone fractures. The potential of periosteum and its resident cells could thereby be utilized effectively in tissue-engineering methods and tissue regenerative medicine.

scholarly journals Robotic in situ 3D bio-printing technology for repairing large segmental bone defects

2020 ◽  
Author(s):  
Lan Li ◽  
Jianping Shi ◽  
Kaiwei Ma ◽  
Jing Jin ◽  
Peng Wang ◽  
...  
Keyword(s):  
Bone Defects ◽  
Printing Technology ◽  
Segmental Bone ◽  
Segmental Bone Defects

scholarly journals Hi-PoAD technique for Adolescent Idiopathic Scoliosis in Adult: Personal case series

2021 ◽  
Author(s):  
Cesare Faldini ◽  
Francesca Barile ◽  
Fabrizio Perna ◽  
Stefano Pasini ◽  
Michele Fiore ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Idiopathic Scoliosis ◽  
Case Series ◽  
Deformity Correction ◽  
Pedicle Screws ◽  
Mechanical Complication ◽  
Non Union ◽  
Implant Retention ◽  
Surgical Data

Abstract Purpose The aim of this article is to present an original surgical technique for the treatment of rigid Adult Idiopathic Scoliosis (AdIS) and the results at minimum 2 years follow-up in a cohort of 40 patients. Methods We retrospectively reviewed 40 patients affected by rigid AdIS, older than 40 years and operated with a posterior one stage surgical technique summarized with the acronym Hi-PoAD, (high-density pedicle screws, Ponte osteotomies, asymmetric rods contouring, direct vertebral rotation). The demographic and surgical data were collected, and the improvement of clinical scores and radiologic parameters was obtained after surgery, at 1 and 2 years and at final follow-up, to assess deformity correction, coronal and sagittal balance and clinical outcome. Results The average follow-up was 2.9 years (range 2–3.5). Average coronal Cobb angle decreased from 65.0° ± 8.4 to 18.9° ± 3.9 (p < 0.01). Rotation sagittal angle decreased from 26.2° ± 4.4° to 12.4° ± 2.8° (p < 0.01). Mean thoracic kyphosis improved from 23.1° ± 3.6° to 36.0° ± 3.9°. SRS-22 improved form 2.9 ± 0.4 to 3.7 ± 0.6 (p < 0.01). Four early post-operative deep wound infections were observed, all healed after debridement and implant retention. No mechanical complication, junctional kyphosis, deformity progression or non-union were recorded at the last follow-up. Conclusions Hi-PoAD technique proved to be safe and effective in the treatment of rigid Adult Idiopathic Scoliosis. The reason for the success is related to the combined strategies adopted, that dissipates corrective forces over several levels, reducing mechanical stress at the screw–bone interface and optimizing corrective potential.

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