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 During the past seven years we have had the opportunity to participate in the initial clinical validation of an exciting new biomaterial designed for use in adult orthopedic reconstruction. Trabecular metal (TM) is a porous tantalum construct that is a stand alone material which has the appearance and structural characteristics of cancellous bone. It is composed of elemental tantalum which has a high strength to weight ratio yet has low stiffness. TM is 75 percent porous and all pores are fully interconnected. It is biologically compatible and in canine studies has demonstrated more rapid bone and soft tissue ingrowth than previously tested porous biomaterials.
We participated in a multi-center study, which investigated its use in a novel acetabular component for use in total hip arthroplasty. These data have demonstrated better initial compatibility with host bone than previously seen with other designs and no adverse consequences of its use. This information has been presented nationally and has been accepted for publication in the Journal of Arthroplasty.
Porous tantalum is currently being used as a substrate for the tibial base-plate in total knee arthroplasty. We have experience with its use in over 500 patients and are currently reviewing the results. There are many applications for the use of TM as a substitute for allograft bone in cases of bone loss from trauma or infection. A recent publication in the Journal of Bone and Joint Surgery reviews the scope of the clinical applications of this material and our experience with its use.
We have also been interested in the management of blood loss in the peri-operative period during total hip and knee procedures. We recently completed a retrospective analysis of over 400 procedures in which the Orthopat® cell saver was used for collection of lost blood and re-infusion of red blood cells. The practice of tourniquet deflation prior to wound closure in total knee replacement for the purpose of obtaining hemostasis was specifically investigated with reference to its influence on total blood loss. These outcome data indicate that this practice is not beneficial to the patient and, in fact, actually increases total blood loss and the risk of auto-transfusion.
Our plans for the future include further studies on the use of porous tantalum in joint replacement, the effects of aprotinin on transfusion requirements and blood loss in patients undergoing elective primary total hip replacement.
Thomas O’Keefe, M.D., Orthopedic Surgery
CLINICAL INVESTIGATORS
Wallace Arneson, M.D., General Surgery
Ronald Bogdasarian, M.D., Otolaryngology
Jason Brodkey, M.D., Neurosurgery
Michael Chrissos, M.D., Orthopedic Surgery
Robert Cleary, M.D., General and Colorectal Surgery
David Denzin, M.D., Orthopedic Surgery
Randal Desrochers, M.D., Chair, Department of Surgery, St. Joseph Mercy Saline Hospital
Mark Falahee, M.D., Neurosurgery
Laith Farjo, M.D., Orthopedic Surgery
Richard Flanagan, M.D., General and Colorectal Surgery
Douglas Geiger, M.D., Neurosurgery
Keow Mei Goh, M.D., Urology
Brian Halloran, M.D., Vascular Surgery
Fred Hankin, M.D., Head, Section of Orthopedic Surgery
Michael Heidenreich, M.D., Vascular Surgery
John Henke, M.D., Orthopedic Surgery
Laurence Ho, M.D., Otolaryngology
Paul Hoff, M.D., Otolaryngology
James Holmes, M.D. Orthopedic Surgery
Verne L. Hoshal, Jr., M.D., General Surgery
Paul Izenberg, M.D., Plastic Surgery
Salam Jafar, M.D. Head., Section of Radiation Oncology
David Janda, M.D., Orthopedic Surgery
Gregory Katz, M.D., Ophthalmology
Beth Kimball, M.D., General Surgery
Eduardo Kleer, M.D., Urology
Bobby Kong, M.D., Cardio/Thoracic Surgery
Edward Kreske, M.D., General Surgery
Jennifer Kulik, M.D., General Surgery
Richard Lampman, Ph.D., General Surgery
Edward Loniewski, D.O., Orthopedic Surgery
John Markley, Jr. M.D., Plastic Surgery
Michael Masini, M.D., Orthopedic Surgery
Robert Mazzeo, M.D., General Surgery
Timothy McHugh, M.D., Urology
Thomas O’Keefe, M.D., Orthopedic Surgery
Robert Oneal, M.D., Plastic Surgery
Richard Pomerantz, M.D., General Surgery
Andrew Pruitt, M.D., Head, Section of Cardio/Thoracic Surgery
Michael Sarosi, M.D., Interventional Radiology
Oliver Soldes, M.D., Pediatric Surgery
Hugh Solomon, M.D., Head, Section of Urology
Manak Sood, M.D., Cardio/Thoracic Surgery
Adrienne Spirt, M.D., Ph.D., Orthopedic Surgery
Warren Taranow, D.O., Orthopaedic Surgery
Walter Whitehouse, Jr., M.D., Chair, Department of Surgery
Seth Wolk, M.D., Vascular Surgery
Scholarly Activities - Surgery
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