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The development of bioactivity in bioinert metallic alloys is a field of interest aiming to improve some aspects of these materials for implant applications. New Co63 Cr28 W9-x Tax alloys with different Ta concentrations (x = 0, 2, 4, 6, and 9% w/w) were synthesized in the work reported here. The alloys were characterized by x-ray diffraction, volumetric density, Vickers microhardness, atomic force microscopy, scanning electron microscopy (SEM), and energy-dispersion x-ray spectroscopy (EDS). Bioactivity properties were evaluated by in vitro tests with simulated body fluid (SBF). In vivo assays were performed to assess biocompatibility. The influence of surface thermochemical treatment and Ta insertion on the bioactive properties of the alloys was investigated. The results showed that the alloy structure comprises εCo and αCo phases, with cobalt as a matrix with Cr, W, and Ta as a solid solution. TaCo2 phase is observed in the alloys with 4, 6, and 9% w/w of Ta, and its amount increase as Ta concentration increases. Volumetric density is reduced (from 8.78 ± 0.06 to 8.56 ± 0.09 g/cm3 ) as Ta concentration increases (from 0% to 9% w/w) mainly due to the lower density of the tantalum compared to the tungsten metal. On the other hand, the TaCo2 phase contributes to the increase of Vickers's hardness by ~17.6% for the alloy with 9% Ta (394.7 ± 8.1 HV) compared with Co63 Cr28 W9 (336 ± 5 HV). The topographic analysis showed increased roughness and adhesion due to the nucleation of Ta1.1 O1.05 and Ca2 Ta2 O7 crystals after surface thermochemical treatment. The roughness and adhesion increase from 16.9 ± 0.6 nm and 8.3 ± 1.8 nN (untreated surface) to 255.7 ± 17.7 nm and 24.1 ± 12.6 nN (treated surface), respectively, for the Co63 Cr28 Ta9 alloy. These results suggest that thermochemical treatment provides surface conditions favorable to hydroxyapatite (HA) nucleation. The SEM and EDS data showed the nucleation of spongy structures, consistent with HA, composed mainly of Ca and P, indicating that oxides tantalum promoted a bioactive response on the sample's surface. The biological assay corroborated the alloy's safety and applicability, highlighting its potential in biomedical application since no harmful effects were observed.
Assuntos
Ligas , Tantálio , Ligas/farmacologia , Tantálio/farmacologia , Durapatita/química , Metais , Próteses e Implantes , Propriedades de Superfície , Teste de MateriaisRESUMO
Este artigo propõe relacionar a trajetória e tragédia do mito grego Tântalo às conjunturas históricas, ressaltando o papel de destaque do corpo na construção da sociedade. Se alimenta de referências filosóficas, principalmente de Friedrich Wilhelm Nietzsche e de Arthur Schopenhauer e literárias de Franz Kafka e Augusto dos Anjos para poder instaurar um olhar sobre o corpo enquanto instrumento reflexivo e, por conseguinte, refém das barbáries corporais e psicológicas na história.
This article proposes to relate the trajectory and tragedy of the Greek myth Tantalus to the historical conjunctures, emphasizing the prominent role of the body in the construction of the society. It feeds on philosophical references, especially from Friedrich Nietzsche and Arthur Schopenhauer and from literary works by Franz Kafka and Augusto dos Anjos, in order to establish a look at the body as a reflexive instrument and, therefore, a hostage to the corporal and psychological barbarism in history.
Este artículo propone relacionar la trayectoria y tragedia del mito griego Tántalo a las coyunturas históricas, resaltando el papel destacado del cuerpo en la construcción de la sociedad. Se alimenta de referencias filosóficas, principalmente de Friedrich Wilhelm Nietzsche y de Arthur Schopenhauer y literarias de Franz Kafka y Augusto de los Ángeles para poder instaurar una mirada sobre el cuerpo como instrumento reflexivo y, por consiguiente, rehén de las barbarie corporales y psicológicas en la historia.
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AIM: To evaluate biological behavior of human peripheral mononuclear cells (PBMC) in contact with porous tantalum (PT) and Porphyromonas gingivalis (Pg). METHODS: Pg was incubated for 8 hours. The groups formed were: PBMC (control), PBMC + PT, PBMC + Pg and PBMC + PT + Pg. Cell viability was evaluated using MTT assay. The morphology and adhesion of PBMC to PT was evaluated using scanning electron microscopy. Expression of interleukin (IL)-10, transforming growth factor (TGF)-ß, matrix metallopeptidase (MMP)-9 and receptor activator of nuclear factor-κΒ ligand (RANKL) was determined by enzyme-linked immunosorbent assay. RESULTS: MTT assay revealed that PT did not interfere in the mitochondrial activity of PBMC (P > .05). Scanning electron microscopy showed the adherence of PBMC to PT. IL-10 levels in PBMC + PT were similar to PBMC and lower than PBMC + Pg. TGF-ß levels in PBMC + PT were higher than PBMC and PBMC + Pg. MMP-9 levels in PBMC + PT were similar to PBMC and lower than PBMC + Pg and PBMC + PT + Pg. RANKL levels in PBMC + PT were lower than in PBMC. CONCLUSION: PT did not affect PBMC viability, allowed cell adhesion, reduced expression of RANKL and enhanced TGF-ß in comparison with the control group.
Assuntos
Porphyromonas gingivalis , Tantálio , Humanos , Leucócitos , Leucócitos Mononucleares , PorosidadeRESUMO
Objective The objective of the present study is to evaluate the restoration capacity of the hip anatomic rotation center with the use of acetabular tantalum cups, associated or not with addition wedges. Methods Retrospective analysis of patients undergoing hip arthroplasty revision using tantalum between June 2013 and April 2017. The abduction angle of the acetabular component and the horizontal and vertical distances of the component to the center of anatomical rotation of the hip were evaluated. The measurements were made through baseline radiographs performed in the preoperative period and at the last follow-up visit. Results A sample of 21 patients was obtained, 11 (52%) men and 10 (48%) women, with a mean age of 62 ± 13 years old. The mean abduction angle of the acetabular cup decreased from 48.76° ± 13.88 ° in the preoperative period to 38.52° ± 10.08 ° in the postoperative period, and this difference was statistically significant ( p = 0.001). The distances from the center of rotation of the prosthesis relative to the center of anatomical rotation of the hip were also lower after revision surgery with tantalum. The mean horizontal distance of 12.74 ± 10.59 mm was reduced to 7.11 ± 4.84 mm, and the mean vertical distance was reduced from 14.79 ± 10.05 mm to 4.89 ± 6.21 mm, and these reductions were statistically significant ( p < 0.001). Conclusion Hip arthroplasty revision with tantalum cups, associated or not with addition wedges, significantly recovered the anatomical rotation center of the hip.
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Abstract Objective The objective of the present study is to evaluate the restoration capacity of the hip anatomic rotation center with the use of acetabular tantalum cups, associated or not with addition wedges. Methods Retrospective analysis of patients undergoing hip arthroplasty revision using tantalum between June 2013 and April 2017. The abduction angle of the acetabular component and the horizontal and vertical distances of the component to the center of anatomical rotation of the hipwere evaluated. The measurements were made through baseline radiographs performed in the preoperative period and at the last follow-up visit. Results A sample of 21 patients was obtained, 11 (52%) men and 10 (48%) women, with amean age of 62 ± 13 years old. The mean abduction angle of the acetabular cup decreased from 48.76° ± 13.88 ° in the preoperative period to 38.52° ± 10.08 ° in the postoperative period, and this difference was statistically significant (p = 0.001). The distances from the center of rotation of the prosthesis relative to the center of anatomical rotation of the hip were also lower after revision surgery with tantalum. The mean horizontal distance of 12.74 ± 10.59 mm was reduced to 7.11 ± 4.84 mm, and the mean vertical distance was reduced from 14.79 ± 10.05 mm to 4.89 ± 6.21 mm, and these reductions were statistically significant (p < 0.001). Conclusion Hip arthroplasty revision with tantalum cups, associated or not with addition wedges, significantly recovered the anatomical rotation center of the hip.
Resumo Objetivo O objetivo do presente estudo é avaliar a capacidade de restauração do centro de rotação anatômico do quadril com uso de copas acetabulares de tântalo associado ou não a cunhas de adição. Métodos Análise retrospectiva dos pacientes submetidos a revisão de artroplastia do quadril comuso de tântalo entre o período de junho de 2013 e abril de 2017. Foramavaliados o ângulo de abdução do componente acetabular e as distâncias horizontal e vertical do componenteao centro de rotação anatômicodoquadril.Asmedidas foramrealizadas através de radiografias da bacia realizadas no pré-operatório e na última visita de seguimento. Resultados Obteve-se uma amostra de 21 pacientes, 11 (52%) homens e 10 (48%) mulheres, com média de idade de 62 ± 13 anos. O ângulo médio de abdução da copa acetabular reduziu de 48,76° ± 13,88° no pré-operatório para 38,52° ± 10,08° no pósoperatório, sendo esta diferença estatisticamente significativa (p = 0,001). As distâncias do centro de rotação da prótese em relação ao centro de rotação anatômico do quadril também foram menores após a cirurgia de revisão com o tântalo. A distância média horizontal de 12,74 ± 10,59 mm foi reduzida para 7,11 ± 4,84 mm, e a distância média vertical foi reduzida de 14,79 ± 10,05 mm para 4,89 ± 6,21 mm, sendo essas reduções estatisticamente significativas (p < 0,001). Conclusão As revisões de artroplastia do quadril comcopas de tântalo, associadas ou não a cunhas de adição, recuperaram de forma significativa o centro de rotação anatômico do quadril.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Tantálio , Artroplastia de Quadril , AcetábuloRESUMO
The aim of this study was to tailor the deposition parameters of magnetron sputtering to synthetize tantalum oxide (TaxOy) films onto commercially pure titanium (cpTi) surface. The structural and optical properties, morphology, roughness, elemental chemical composition and surface energy were assessed. The impact of TaxOy films on initial Streptococcus sanguinis adhesion was investigated. The morphology and spreading of pre-osteoblastic (MC3T3-E1) cells on a crystalline tantalum oxide film were evaluated. TaxOy films with estimated thickness of 600â¯nm and different structures (amorphous or crystalline) were produced depending on the various oxygen flow rates and parameters used. X-ray diffraction analysis revealed that the 8 O2 sccm (600⯰C/400â¯W) group showed crystallization corresponding to the ß-Ta2O5 phase. Optical analysis showed that the 4 O2 sccm (200⯰C 300â¯W) to 8 O2 sccm (600⯰C 300â¯W) groups and 10 O2 sccm (200⯰C 300â¯W) group presented regular and large-amplitude interference oscillations, suggesting high optical homogeneity of the films. The crystalline ß-Ta2O5 coating showed higher roughness and surface energy values than the other groups (Pâ¯<â¯.05) and was biocompatible. Compared with cpTi, the amorphous and crystalline tantalum oxide films did not increase bacterial adhesion (Pâ¯>â¯.05). By tailoring the deposition parameters, we synthetized a crystalline ß-Ta2O5 coating that improved titanium surface properties and positively affected cell spreading and morphology, making it a promising surface treatment for titanium-based implants.
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Materiais Biocompatíveis/química , Tecnologia Biomédica/métodos , Tantálio/química , Animais , Linhagem Celular , Materiais Revestidos Biocompatíveis/química , Camundongos , Osteoblastos/citologia , Osteoblastos/ultraestrutura , Refratometria , Termodinâmica , Difração de Raios XRESUMO
OBJECTIVE: To evaluate a mixed technique of acetabular reconstruction, which uses trabecular metal in the form of tantalum augments associated with lyophilized bovine xenograft. METHODS: Fifteen patients were evaluated prospectively, who underwent acetabular reconstruction with impacted lyophilized bovine xenograft associated with the use of tantalum augments. The main outcome was the failure of the tantalum-bone interface. RESULTS: The population had a mean age of 58.33 years ± 14.27; the majority was female, 80%. Of the total subjects, 66.7% were operated for failure in primary arthroplasty. The mean follow-up time was 45.2 months ± 11.39. The failure rate of the method in the period and population studied was 6.7%. CONCLUSION: An extremely high index (93.3%) of success was observed in an average time of 45.2 months of follow-up. Data were comparable to current literature, demonstrating that the technique employed and proposed is adequate for hip reconstruction in young patients.
OBJETIVO: Avaliar uma técnica mista de reconstrução acetabular que usa metal trabecular na forma de cunhas de tântalo associadas com enxerto ósseo bovino liofilizado. MÉTODOS: Foram avaliados prospectivamente 15 pacientes submetidos à reconstrução acetabular com enxerto bovino liofilizado impactado associado ao uso de cunhas de tântalo. O principal desfecho avaliado foi a falha da interface tântalo-osso. RESULTADOS: A população apresentou idade média de 58,33 anos ± 14,27, a maioria do sexo feminino 80%. Do total, 66,7% foram operados por falha da artroplastia primária. O tempo médio de seguimento foi de 45,2 meses ± 11,39 meses. A taxa de falha do método no período e na população estudada foi de 6,7%. CONCLUSÃO: Observou-se um índice extremamente elevado (93,3%) de sucesso em um tempo médio de 45,2 meses de seguimento. Os dados são comparáveis à literatura corrente, o que demonstra que a técnica empregada e proposta é adequada para reconstrução de quadril em pacientes jovens.
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The object of this work was the deposition of a Ta-Hf-C thin film with a gold interlayer on stainless steel, via the physical vapor deposition (PVD) technique, in order to evaluate the properties of different systems subjected to micro-abrasive wear phenomena generated by alumina particles in Ringer's solution. The surface characterization was performed using a scanning electron microscope (SEM) and atomic force microscope (AFM). The crystallographic phases exhibited for each coating were obtained by X-ray diffraction (XRD). As a consequence of modifying the composition of Ta-Hf there was evidence of an improvement in the micro-abrasive wear resistance and, for each system, the wear constants that confirm the enhancement of the surface were calculated. Likewise, these surfaces can be bioactive, generating an alternative to improve the biological fixation of the implants, therefore, the coatings of TaC-HfC/Au contribute in the development of the new generation of orthopedic implants.
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AIM: To evaluate the biocompatibility and mineralized nodule formation of an experimental tricalcium silicate cement with tantalum oxide (TSC/Ta2 O5 ) as radiopacifier, Neo MTA Plus (Avalon Biomed Inc., Bradenton, FL, USA) and MTA (Angelus, Londrina, PR, Brazil) on human osteoblast-like cells (Saos-2). METHODOLOGY: Biocompatibility was evaluated by 3-(4,5-dimethyl-thiazoyl)-2,5-diphenyl-tetrazolium bromide (MTT) and neutral red (NR) assays, after exposure of Saos-2 to cement extracts at 1 : 1, 1 : 2, 1 : 4 and 1 : 8 dilutions for 24 h. Bioactivity was evaluated by alkaline phosphatase (ALP) activity, and calcium deposits were detected with alizarin red staining (ARS). Statistical analysis was performed with analysis of variance and Bonferroni or Tukey post-test (α = 0.05). RESULTS: The MTT assay revealed lower cytotoxicity for NEO and MTA (P < 0.05), and higher for TSC/Ta2 O5 at 1 : 1 and 1 : 2 dilutions when compared to serum-free medium - control (P > 0.05). At 1 : 4 dilution, the TSC/Ta2 O5 cytotoxicity was similar to the control (P > 0.05). At 1 : 8 dilution, cell viability was significantly greater than the control (P < 0.05). Saos-2 cell viability performed using the NR assay at all dilutions revealed no cytotoxic effect of MTA, NEO and TSC/Ta2 O5 . ALP activity at 1 and 3 days was similar to the control (P > 0.05). TSC/Ta2 O5 had significantly greater ALP activity at 7 days when compared with the control (P < 0.05). All materials induced the production of mineralized nodules, and NEO produced significantly more mineralized nodules than MTA and TSC/Ta2 O5 (P < 0.05). CONCLUSIONS: Neo MTA Plus and TSC/Ta2 O5 were biocompatible and induced ALP activity in Saos-2 cells. Both materials induced mineralized nodule formation by Saos-2 with Neo MTA Plus producing significantly more.
Assuntos
Materiais Biocompatíveis/farmacologia , Compostos de Cálcio/farmacologia , Cimentos Dentários/farmacologia , Osteoblastos/efeitos dos fármacos , Óxidos/farmacologia , Agentes de Capeamento da Polpa Dentária e Pulpectomia/farmacologia , Silicatos/farmacologia , Tantálio/farmacologia , Fosfatase Alcalina/metabolismo , Cálcio/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Combinação de Medicamentos , Humanos , Técnicas In Vitro , Teste de Materiais , Sais de TetrazólioRESUMO
Abstract Objective To evaluate a mixed technique of acetabular reconstruction, which uses trabecular metal in the form of tantalum augments associated with lyophilized bovine xenograft. Methods Fifteen patients were evaluated prospectively, who underwent acetabular reconstruction with impacted lyophilized bovine xenograft associated with the use of tantalum augments. The main outcome was the failure of the tantalum-bone interface. Results The population had a mean age of 58.33 years ± 14.27; the majority was female, 80%. Of the total subjects, 66.7% were operated for failure in primary arthroplasty. The mean follow-up time was 45.2 months ± 11.39. The failure rate of the method in the period and population studied was 6.7%. Conclusion An extremely high index (93.3%) of success was observed in an average time of 45.2 months of follow-up. Data were comparable to current literature, demonstrating that the technique employed and proposed is adequate for hip reconstruction in young patients.
Resumo Objetivo Avaliar uma técnica mista de reconstrução acetabular que usa metal trabecular na forma de cunhas de tântalo associadas com enxerto ósseo bovino liofilizado. Métodos Foram avaliados prospectivamente 15 pacientes submetidos à reconstrução acetabular com enxerto bovino liofilizado impactado associado ao uso de cunhas de tântalo. O principal desfecho avaliado foi a falha da interface tântalo-osso. Resultados A população apresentou idade média de 58,33 anos ± 14,27, a maioria do sexo feminino 80%. Do total, 66,7% foram operados por falha da artroplastia primária. O tempo médio de seguimento foi de 45,2 meses ± 11,39 meses. A taxa de falha do método no período e na população estudada foi de 6,7%. Conclusão Observou-se um índice extremamente elevado (93,3%) de sucesso em um tempo médio de 45,2 meses de seguimento. Os dados são comparáveis à literatura corrente, o que demonstra que a técnica empregada e proposta é adequada para reconstrução de quadril em pacientes jovens.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Acetábulo , Artroplastia de Quadril , Transplante Ósseo , Instrumentos Cirúrgicos , TantálioRESUMO
BACKGROUND: Search for materials that may either replace titanium dental implants or constitute an alternative as a new dental implant material has been widely studied. As well, the search for optimum biocompatible metal surfaces remains crucial. So, the aim of this work is to develop an oxidized surface layer on tantalum using plasma electrolytic oxidation (PEO) similar to those existing on oral implants been marketed today. METHODS: Cleaned tantalum samples were divided into group 1 (control) and groups 2, 3, and 4 (treated by PEO for 1, 3, and 5 min, respectively). An electrolytic solution diluted in 1-L deionized water was used for the anodizing process. Then, samples were washed with anhydrous ethyl alcohol and dried in the open air. For complete anodic treatment disposal, the samples were immersed in acetone altogether, taken to the ultrasonic tank for 10 min, washed again in distilled water, and finally air-dried. For the scanning electron microscopy (SEM) analysis, all samples were previously coated with gold; the salt deposition analysis was conducted with an energy-dispersive X-ray spectroscopy (EDS) system integrated with the SEM unit. RESULTS: SEM images confirmed the changes on tantalum strips surface according to different exposure times while EDS analysis confirmed increased salt deposition as exposure time to the anodizing process also increased. CONCLUSIONS: PEO was able to produce both surface alteration and salt deposition on tantalum strips similar to those existing on oral implants been marketed today.
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OBJECTIVES: the aim of this study was to evaluate the surgical technique and determine the initial results, with a minimum follow-up of two years, from total knee arthroplasty revisions in which trabecular metal cones made of tantalum were used at the Knee Surgery Center of the National Institute of Traumatology and Orthopedics (INTO) or at the authors' private clinic between July 2008 and December 2010. METHODS: ten patients were included in the study prospectively, through clinical and radiographic evaluations. RESULTS: seven patients presented evolution without complications relating to the tantalum cones used. Five of these patients said that they did not have any pain and all of them were able to walk without needing crutches. In all the cases, we observed that osseointegration of the tantalum cones had occurred. No migration or loosening of the implants was observed, nor was osteolysis. CONCLUSION: use of trabecular metal cones made of tantalum for treating AORI type II or II bone defects was capable of providing efficient structural support to the prosthetic revision implants, in evaluations with a short follow-up...
OBJETIVOS: avaliar a técnica cirúrgica e determinar os resultados iniciais, com seguimento mínimo de dois anos, das revisões de artroplastia total do joelho nas quais cones de metal trabecular tântalo foram empregados pelo Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia (Into) ou na clínica privada dos autores de julho de 2008 a dezembro 2010. MÉTODOS: foram incluídos no estudo 10 pacientes, prospectivamente em avaliação clínica e radiográfica. RESULTADOS: sete pacientes apresentaram evolução sem complicações relacionadas ao uso de cones de tântalo, cinco negam dor e todos deambulam sem necessidade de muletas. Em todos os casos, verificamos osteointegração dos cones de tântalo e não foi observada migração ou soltura de implantes, assim como osteólise. CONCLUSÃO: o uso de cones de metal trabecular tântalo para tratamento de defeitos ósseos tipo II ou III Aori apresenta-se capaz de prover suporte estrutural eficiente aos implantes protéticos de revisão em avaliação de curto seguimento...
Assuntos
Humanos , Artroplastia do Joelho , Osseointegração , Próteses e Implantes , Instrumentos CirúrgicosRESUMO
OBJECTIVES: the aim of this study was to evaluate the surgical technique and determine the initial results, with a minimum follow-up of two years, from total knee arthroplasty revisions in which trabecular metal cones made of tantalum were used at the Knee Surgery Center of the National Institute of Traumatology and Orthopedics (INTO) or at the authors' private clinic between July 2008 and December 2010. METHODS: ten patients were included in the study prospectively, through clinical and radiographic evaluations. RESULTS: seven patients presented evolution without complications relating to the tantalum cones used. Five of these patients said that they did not have any pain and all of them were able to walk without needing crutches. In all the cases, we observed that osseointegration of the tantalum cones had occurred. No migration or loosening of the implants was observed, nor was osteolysis. CONCLUSION: use of trabecular metal cones made of tantalum for treating AORI type II or II bone defects was capable of providing efficient structural support to the prosthetic revision implants, in evaluations with a short follow-up.
OBJETIVOS: avaliar a técnica cirúrgica e determinar os resultados iniciais, com seguimento mínimo de dois anos, das revisões de artroplastia total do joelho nas quais cones de metal trabecular tântalo foram empregados pelo Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia (Into) ou na clínica privada dos autores de julho de 2008 a dezembro 2010. MÉTODOS: foram incluídos no estudo 10 pacientes, prospectivamente em avaliação clínica e radiográfica. RESULTADOS: sete pacientes apresentaram evolução sem complicações relacionadas ao uso de cones de tântalo, cinco negam dor e todos deambulam sem necessidade de muletas. Em todos os casos, verificamos osteointegração dos cones de tântalo e não foi observada migração ou soltura de implantes, assim como osteólise. CONCLUSÃO: o uso de cones de metal trabecular tântalo para tratamento de defeitos ósseos tipo II ou III Aori apresenta-se capaz de prover suporte estrutural eficiente aos implantes protéticos de revisão em avaliação de curto seguimento.
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Objectives: To evaluate short-term clinical results of patients performed acetabular revision surgery using a Trabecular Tantalum coated modular acetabular cups. Materials and Methods: This is a retrospective and descriptive analysis of a serie of 32 consecutive patients (34 hips) with acetabular revision surgery (23 women, 9 men, mean age 70.7 years), mean follow-up 32 month (12-60). The Paprosky and the AAOS acetabular defects classifications were assessed. According to Paprosky acetabular defects classification, there were eleven type I, two IIA, three IIB, nine IIC, seven IIIA and two IIIB. According to AAOS acetabular defects classification there were thirteen patients with type 1, nine patients with type 2, ten type 3 and two type 4. The percentage of own acetabular bone in contact with the new cup was recorded for each patient at the time of surgery and was 45 percent (range from 20 to 80 percent), with 23 patients presenting less than 50 percent of bone contact (mean 35 percent). Postoperatively, osseous integration was radiographically assessed. Functional results were evaluated according to the Harris Hip Score (HSS). The complications related to the implant were also recorded. Results: In all radiographic assessments performed at 3, 6 and 12 month postoperatively an integrated cup without signs of migration or osteolysis was observed. Four patients (11.8 percent) presented recurrent hip dislocation that required a revision surgery without further cup revision. The final clinical assessment was performed at a mean of 26 month after surgery (12-60) with a mean HHS of 91.8 points. Conclusion: Trabecular tantalum coated modular acetabular cups in acetabular revision surgery shows good short term clinical results even with acetabular defects greater than 50 percent. No cup loosening was observed in these series.
Objetivo: Evaluar los resultados clínicos a corto plazo de pacientes sometidos a cirugía de revisión acetabular utilizando cotilos modulares con superficie de metal trabecular de tantalio. Material y Métodos: Estudio retrospectivo-descriptivo de una serie consecutiva de 32 pacientes (34 caderas) sometidos a cirugía de revisión acetabular (23 mujeres, 9 hombres, edad promedio 70,7 años), seguimiento promedio 32 meses (12-60). Se clasifican los defectos acetabulares de acuerdo ala clasificación de Paprosky y de la AAOS. Según la clasificación de Paprosky de los defectos acetabulares, 11 pacientes tenían categoría I, 2 categoría IIA, 3 categoría IIB, 9 categoría IIC, 7 categoría IIIA y 2 categoría IIIB. Según la clasificación de la AAOS, 13 pacientes correspondieron a nivel 1, 9 pacientes a nivel 2, 10 a nivel 3 y 2 a nivel 4. Se registra el porcentaje de hueso propio acetabular en contacto con el nuevo cotilo de cada paciente que fue en promedio 45 por ciento (20-80 por ciento), presentándose en 23 caderas un porcentaje < 50 por ciento, el cual fue en promedio 35 por ciento. En el postoperatorio se evalúa la integración ósea mediante radiografías de pelvis. Se evalúan los resultados funcionales mediante el HHS (Harris Hip Score) y las complicaciones postoperatorias relacionadas con el implante. Resultados: En todas las radiografías postoperatorias realizadas a los 3, 6 y 12 meses se evidenciaba el cotilo integrado, sin signos de migración ni osteolisis. Cuatro pacientes (11,8 por ciento) presentaron luxaciones recidivantes de cadera, las cuales requirieron de una cirugía de revisión sin recambio del cotilo. La última evaluación clínica fue en promedio 26 meses tras la cirugía (12-60 meses) constatándose un HHS promedio de 91,8 puntos. Conclusión: El uso de cotilos modulares con revestimiento de metal trabecular de tantalio en cirugías de revisión acetabular presenta buenos resultados clínicos a corto plazo incluso en defectos óseos acetabulares superiores...