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The use of trabecular metal in the tibial surface may increase prosthetic survival in the population with severe or morbid obesity (BMI > 35 kg/m²). A prospective, descriptive study was conducted of patients with a BMI > 35 kg/m² who underwent total knee replacement with a prosthesis with trabecular metal. Minimal follow-up was two years. The statistical analysis was done with Student's t test; the Knee Society Score and the Western Ontario and McMaster Universities Osteoarthritis Index were applied preoperatively and postoperatively. The χ2 test was applied to the BMI values relating them with more or less radiolucent images. The total number of patients was 39, but three were excluded for not having the radiographic follow-up. Mean follow-up was 34 months (25-43); 35 were females, mean age was 69.4 years (57-81), mean BMI was 39.43 kg/m² (35-55). All patients had grades 3 and 4 tricompartmental arthrosis. The KSS (R and F) and WOMAC scales, with a 95% confidence interval, showed a statistically significant improvement in the assessment of preoperative results and at the end of the follow-up. Only a few studies measure long-term implant survival. Most authors define survival as the absence of the need to revise prosthetic implants. The end point of survival is the removal or exchange of prosthetic components. Trabecular metal (TM) is currently used in orthopedic surgery and its clinical applications are increasing more and more with good results. [ABSTRACT FROM AUTHOR]

Background: We are currently observing an increase in the incidence of acetabular fractures in elderly patients due to the increase in this population age group. These fractures represent a challenge to the traumatologist because in some cases there is the surgical alternative of combining fixation with total acute hip arthroplasty. In this paper we explore the use of trabecular metal combining the stability provided by a cage with potential bone incorporation, applying the principles of revision surgery to speed-up the healing process without the limitations resulting from the restrictions in the load of the operated limb. Material and methods: We assessed the clinical and radiological results, with a 2-year follow-up, after total hip arthroplasty for the acute treatment of an acetabular fracture of the anterior column, with involvement of the quadrilateral lamina in an elderly 85 year-old patient. Results: Important pain relief occurred, with functional improvement and an appropriate range of motion using the Merle d'Aubigné system. Radiologically, the graft areas in the particles surrounding the acetabular component were uniformly integrated. No loosening, screw rupture or implant migration occurred. Conclusions: This indication using a revision technique based on a trabecular metal reconstruction cage should be considered as an alternative to bear in mind in these patients. [ABSTRACT FROM AUTHOR]

Introduction: New metal-onmetal hip replacement models emerged in the 1990 with modifications of the previous designs and alloys. This led to expect a lesser rate of ion and particle release in the body with the resulting decrease in wear, osteolysis and loosening. Objective: To measure blood and urine chromium and cobalt ions in a 28 mm metalon- metal tribology during the first postoperative year. Material and methods: Blood and urine cobalt and chromium concentrations were measured in 10 patients (13 prostheses) with the atomic absorption method. The etiology was studied and they were functionally assessed with the Harris functional scale. Adverse metal reactions were also assessed. Results: 8 male and 2 female patients, mean age 54.5 years; 6 had primary coxarthrosis, one was post-traumatic, and 3 had avascular necrosis. The final assessment according to the Harris scale was 92 points. Mean blood chromium was 1.26 ng/l, blood cobalt was 1.033 µg/l; (reference values: chromium 1.4 ng/l and cobalt 1.8 µg/l); only one figure, in a female patient, was found to be higher than normal (chromium 21.2 ng/l and cobalt 15.4 µg/l). Mean urine chromium was 0.95 ng/ml, urine cobalt was 0.53 µg/l (Reference values: chromium: 2.0 ng/ml and cobalt 0.5 µg/l). Conclusions: All patients, with the exception of a female patient, were within the normal ranges. No adverse effect was observed in patients with metal implants with a 28 mm tribology. [ABSTRACT FROM AUTHOR]

Efficacy of osteointegration of tantalum porous systems has been demonstrated through animal experimentation. However, there is a lack of studies that evaluate osteointegration of implants retrieved after a period of implantation in humans. For this study, eight rod implants used for the treatment of avascular necrosis of the femoral head were retrieved following collapse of the femoral head and conversion to total hip arthroplasty. The time of implantation ranged between six weeks and twenty three months. Observation during this study has confirmed effectiveness of osseointegration within this period of time. New bone was observed around and within the porous system of the on rod devices at retrieval date. Bone in growth however, proved to be of a slower and less intense degree than that resulting within animal species during first months after implantation. Nevertheless, the results obtained in the quantitative evaluation of this process proved to be similar to those results achieved by other authors in previous experimental studies. [ABSTRACT FROM AUTHOR]