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Effects of porous tantalum on periprosthetic bone remodeling around metaphyseal filling femoral stem: a multicenter, prospective, randomized controlled study

Periprosthetic bone loss due to adaptive bone remodeling is an important unresolved issue in cementless total hip arthroplasty (THA). The use of porous tantalum on the proximal surface of the femoral stem is expected to decrease postoperative bone loss around the prosthesis through early fixation. W...

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Published in:Scientific reports 2022-01, Vol.12 (1), p.914-9, Article 914
Main Authors: Motomura, Goro, Mashima, Naohiko, Imai, Hiroshi, Sudo, Akihiro, Hasegawa, Masahiro, Yamada, Harumoto, Morita, Mitsuhiro, Mitsugi, Naoto, Nakanishi, Ryosuke, Nakashima, Yasuharu
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creator Motomura, Goro
Mashima, Naohiko
Imai, Hiroshi
Sudo, Akihiro
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Yamada, Harumoto
Morita, Mitsuhiro
Mitsugi, Naoto
Nakanishi, Ryosuke
Nakashima, Yasuharu
description Periprosthetic bone loss due to adaptive bone remodeling is an important unresolved issue in cementless total hip arthroplasty (THA). The use of porous tantalum on the proximal surface of the femoral stem is expected to decrease postoperative bone loss around the prosthesis through early fixation. We conducted a multicenter randomized controlled study to determine if porous tantalum could reduce periprosthetic bone loss after THA. From October 2012 to September 2014, 118 patients (mean age, 61.5 years; 107 females and 11 males) were prospectively enrolled and were randomly allocated at a ratio of 1:1 to either a metaphyseal filling stem with a proximal porous tantalum coating (Trabecular Metal) or a conventional metaphyseal filling stem with fiber mesh coating (VerSys). Patients underwent dual-energy x-ray absorptiometry scans within 1 week after surgery (baseline) and at 6, 12, and 24 months after surgery to assess periprosthetic bone mineral density (BMD) in the 7 Gruen zones. In addition, the Japanese Orthopaedic Association hip score was assessed before surgery and at 6, 12, and 24 months after surgery. In the proximal periprosthetic region (zones 1 and 7), the Trabecular Metal group had significantly smaller reductions in BMD than the VerSys group throughout the study period. In the VerSys group, significant reductions in BMD compared to baseline were seen at each measurement point in all regions, except in zone 6 at 24 months. In the Trabecular Metal group, no significant reductions in BMD relative to baseline were seen in zones 1, 5, or 6 throughout the study period. Both groups demonstrated similar improvement in Japanese Orthopaedic Association hip scores over the study period. This study demonstrated that a proximally coated stem with porous tantalum has superior results over a conventional stem with titanium fiber mesh in terms of periprosthetic bone remodeling.
doi_str_mv 10.1038/s41598-022-04936-2
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The use of porous tantalum on the proximal surface of the femoral stem is expected to decrease postoperative bone loss around the prosthesis through early fixation. We conducted a multicenter randomized controlled study to determine if porous tantalum could reduce periprosthetic bone loss after THA. From October 2012 to September 2014, 118 patients (mean age, 61.5 years; 107 females and 11 males) were prospectively enrolled and were randomly allocated at a ratio of 1:1 to either a metaphyseal filling stem with a proximal porous tantalum coating (Trabecular Metal) or a conventional metaphyseal filling stem with fiber mesh coating (VerSys). Patients underwent dual-energy x-ray absorptiometry scans within 1 week after surgery (baseline) and at 6, 12, and 24 months after surgery to assess periprosthetic bone mineral density (BMD) in the 7 Gruen zones. In addition, the Japanese Orthopaedic Association hip score was assessed before surgery and at 6, 12, and 24 months after surgery. 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The use of porous tantalum on the proximal surface of the femoral stem is expected to decrease postoperative bone loss around the prosthesis through early fixation. We conducted a multicenter randomized controlled study to determine if porous tantalum could reduce periprosthetic bone loss after THA. From October 2012 to September 2014, 118 patients (mean age, 61.5 years; 107 females and 11 males) were prospectively enrolled and were randomly allocated at a ratio of 1:1 to either a metaphyseal filling stem with a proximal porous tantalum coating (Trabecular Metal) or a conventional metaphyseal filling stem with fiber mesh coating (VerSys). Patients underwent dual-energy x-ray absorptiometry scans within 1 week after surgery (baseline) and at 6, 12, and 24 months after surgery to assess periprosthetic bone mineral density (BMD) in the 7 Gruen zones. In addition, the Japanese Orthopaedic Association hip score was assessed before surgery and at 6, 12, and 24 months after surgery. 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subjects 692/308/2779/777
692/4023/1671/63
Absorptiometry, Photon
Aged
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - methods
Bone Density
Bone loss
Bone mineral density
Bone Remodeling
Bone surgery
Coatings
Dual energy X-ray absorptiometry
Female
Femur
Femur - diagnostic imaging
Femur - surgery
Hip
Hip Prosthesis - adverse effects
Humanities and Social Sciences
Humans
Male
Middle Aged
multidisciplinary
Orthopedics
Patients
Porosity
Prospective Studies
Science
Science (multidisciplinary)
Surgery
Surgical mesh
Tantalum
Tantalum - chemistry
Titanium
Total hip arthroplasty
title Effects of porous tantalum on periprosthetic bone remodeling around metaphyseal filling femoral stem: a multicenter, prospective, randomized controlled study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T03%3A12%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effects%20of%20porous%20tantalum%20on%20periprosthetic%20bone%20remodeling%20around%20metaphyseal%20filling%20femoral%20stem:%20a%20multicenter,%20prospective,%20randomized%20controlled%20study&rft.jtitle=Scientific%20reports&rft.au=Motomura,%20Goro&rft.date=2022-01-18&rft.volume=12&rft.issue=1&rft.spage=914&rft.epage=9&rft.pages=914-9&rft.artnum=914&rft.issn=2045-2322&rft.eissn=2045-2322&rft_id=info:doi/10.1038/s41598-022-04936-2&rft_dat=%3Cproquest_doaj_%3E2620906339%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c540t-10df4e3663edbcde4e24a3f53d48aac3e7701f3f89539240a240c4d48c4c6a0c3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2620906339&rft_id=info:pmid/35042918&rfr_iscdi=true