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Tantalum is a good bone graft substitute in tibial tubercle advancement

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Porous tantalum is reportedly a good substitute for structural bone graft in several applications. So far, its use has not been reported in tibial tuberosity anteriorization (TTA) for treatment of isolated degenerative chondral lesions of the patellofemoral joint.

Questions/Purposes

We asked whether the use of this material would produce similar standardized functional scores, pain (VAS), fusion rates, complications, and patient satisfaction to those for bone graft.

Patients and Methods

We performed a randomized, controlled trial in 101 patients (108 knees) scheduled for TTA comparing a porous tantalum implant (57 knees) with an autologous local tibial bone graft (51 knees). The minimum followup was 5 years (mean, 6.2 years; range, 5–8 years).

Results

At the last followup, clinical scores, fusion rates, and maintenance of the anteriorization either were better or similar for the TTA using the tantalum implant depending on the respective parameter. The operative technique was easier and shorter with the tantalum device. Complication and failure rates were greater using bone graft. Patient satisfaction was greater using the tantalum implant.

Conclusions

Porous tantalum provided a reasonable alternative to bone graft in TTA.

Level of Evidence

Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Dr. Antonio Manchón and Dr. Nuria Lavilla for help with radiographs, Ana Labayen for generating the randomization list and for help with the statistical analysis, and Ana Grau, the assisting nurse.

Author information

Authors and Affiliations

  1. Instituto de Cirugía Ortopédica y Traumatología de Barcelona, Río de Oro, 37, 5º3ª, Barcelona, 08034, Spain

    Mariano Fernandez-Fairen PhD, MD, Virginia Querales MD & Alexander Jakowlew MD

  2. Hospital de Cabueñes, Gijón, Asturias

    Antonio Murcia PhD, MD

  3. Universidad Autónoma de Barcelona, Barcelona, Spain

    Jorge Ballester PhD, MD

Authors
  1. Mariano Fernandez-Fairen PhD, MD
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  2. Virginia Querales MD
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  3. Alexander Jakowlew MD
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  4. Antonio Murcia PhD, MD
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  5. Jorge Ballester PhD, MD
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Corresponding author

Correspondence to Mariano Fernandez-Fairen PhD, MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained.

This work was performed at Instituto de Cirugía Ortopédica y Traumatología de Barcelona.

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Fernandez-Fairen, M., Querales, V., Jakowlew, A. et al. Tantalum is a good bone graft substitute in tibial tubercle advancement. Clin Orthop Relat Res 468, 1284–1295 (2010). https://doi.org/10.1007/s11999-009-1115-0

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  • DOI: https://doi.org/10.1007/s11999-009-1115-0

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