Porous tantalum as a structural graft in foot and ankle surgery.
BACKGROUND
Structural bone grafts are often used in foot and ankle surgery to fill gaps, maintain height, length or correction. Bone graft, whether autograft or allograft, has limitations and disadvantages. With porosity and mechanical properties similar to native bone, porous tantalum has been used successfully in hip and knee applications. This study investigates the potential advantages of porous tantalum as a substitute for conventional bone graft in foot and ankle surgery.


METHODS
A retrospective review of 27 arthrodesis procedures was performed of foot and ankle procedures using Trabecular Metal porous tantalum over a period of 5 years. Twenty-five patients were involved. Mean age at the time of surgery was 63 (range, 41 to 80) years. All the patients had pathologies in the foot and ankle that required arthrodesis with structural graft. Average followup was 27 (range, 12 to 72) months.


RESULTS
At final followup the mean American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot/Midfoot score improved from 40.6 (range, 16 to 64) preoperatively to 86.3 (range, 57 to 100) postoperatively (p < 0.001). When the pain component of the AOFAS was examined, the score improved from a mean of 8.2 (range, 0 to 20) to 35.2 (range, 20 to 40), (p < 0.001). At the time of last followup, 56% of patients reported no pain, 40% reported mild occasional pain, and 4% reported moderate pain.


CONCLUSIONS
Porous tantalum therefore, was found to be a viable alternative to conventional bone graft when structural support was required.
American University of Beirut Medical Center, Division of Orthopaedic Surgery, Cairo Street, Hamra, Beirut 1107 2020, Lebanon. bernard.sagherian@aub.edu.lb
Bernard H
BH
Sagherian
Richard J
RJ
Claridge
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation*; D018786:Bone Substitutes / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D033023:Foot Joints / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016062:Porosity; D019736:Prostheses and Implants; D012189:Retrospective Studies; D013635:Tantalum
D018786:Bone Substitutes; D013635:Tantalum