PHYSICOCHEMICAL PROPERTIES AND BIOLOGICAL CHARACTERISTICS OF POROUS TANTALUM AND ITS APPLICATION PROGRESS IN SPINAL SURGERY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XUYan’an ,  JIANGDianming

Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R.China;

Corresponding author：

JIANGDianming, Email: jdm571026@vip.163.com

Keywords：

Porous tantalum; Manufacturing technique; Surface modification; Interbody fusion

DOI：

10.7507/1002-1892.20160159

Video：

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Objective To summarize the physicochemical properties, manufacturing technique, and biological characteristics of porous tantalum and its application progress and related problems in spinal surgery. Methods The domestic and foreign related literature about porous tantalum was summarized and analyzed. Results Porous tantalum is characterized by high porosity, high coefficient of friction, low elastic modulus, good biocompatibility, and superior osseointegration capability. Its manufacture methods include chemical vapor deposition and infiltration technique, foam impregnation and powder metallurgy technique, and heat treatment method. Good clinical efficacy has achieved in the application of porous tantalum interbody fusion Cage in cervical and lumbar fusion surgery, but there is controversy in spinal fusion rate, especially in cervical fusion rate. Surface modification can increase the osseointegration capability of porous tantalum and intervertebral bony fusion. Conclusion Good clinical efficacy has achieved in the application of porous tantalum interbody fusion Cage in lumbar fusion surgery, while there is a dispute in cervical fusion surgery. In order to further observation, studies with more patients and longer follow-up would be needed.

Citation： XUYan’an, JIANGDianming. PHYSICOCHEMICAL PROPERTIES AND BIOLOGICAL CHARACTERISTICS OF POROUS TANTALUM AND ITS APPLICATION PROGRESS IN SPINAL SURGERY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(6): 781-784. doi: 10.7507/1002-1892.20160159 Copy

1.	Kaplar RB, Hills B. Open cell tantalum structures for cancellous bone implants and cell and tissue receptors: US, 5282861[P]. 1994-02-01.
2.	Levine BR, Sporer S, Poggie RA, et al. Experimental and clinical performance of porous tantalum in orthopedic surgery. Biomaterials, 2006, 27(27): 4671-4681.
3.	Yang H, Li J, Zhou Z, et al. Structural preparation and biocompatibility evaluation of highly porous Tantalum scaffolds. Materials Letters, 2013, 100: 152-155.
4.	Zhou Y, Zhu YC. Three-dimensional Ta foams produced by replication of NaCl space-holders. Materials Letters, 2013, 99: 8-10.
5.	李斌, 华永新, 杨光. 多孔钽金属的生物学特性: 近期临床应用安全但远期反应待证实. 中国组织工程研究, 2014, 18(43): 7028-7032.
6.	乔吉超, 奚正平, 汤慧萍, 等. 粉末冶金技术制备金属多孔材料研究进展. 稀有金属材料与工程, 2008, 37(11): 2054-2058.
7.	Zhang Y, Ahn PB, Fitzpatrick DC, et al. Interfacial frictional behavior: cancellous bone, cortical bone, and a novel porous tantalum biomaterial. Journal of Musculoskeletal Research, 1999, 3(4): 245-251.
8.	Matsuno H, Yokoyama A, Watari F, et al. Biocompatibility and osteogenesis of refractory metal implants, titanium, hafnium, niobium, tantalum and rhenium. Biomaterials, 2001, 22(11): 1253-1262.
9.	Jonitz A, Lochner K, Lindner T, et al. Oxygen consumption, acidification and migration capacity of human primary osteoblasts within a three-dimensional tantalum scaffold. J Mater Sci Mate Med, 2011, 22(9): 2089-2095.
10.	Hofstetter W, Sehr H, de Wild M, et al. Modulation of human osteoblasts by metal surface chemistry. J Biomed Mater Res A, 2013, 101(8): 2355-2364.
11.	Sagomonyants KB, Hakim-Zargar M, Jhaveri A, et al. Porous tantalum stimulates the proliferation and osteogenesis of osteoblasts from elderly female patients. J Orthop Res, 2011, 29(4): 609-616.
12.	Bergemann C, Klinkenberg ED, Lüthen F, et al. Proliferation and migration of human osteoblasts on porous three dimensional scaffolds. Materials Science Forum, 2010, 638-642: 506-511.
13.	Unger AS, Lewis RJ, Gruen T. Evaluation of a porous tantalum uncemented acetabular cup in revision total hip arthroplasty: clinical and radiological results of 60 hips. J Arthroplasty, 2005, 20(8): 1002-1009.
14.	Tsao AK, Roberson JR, Christie MJ, et al. Biomechanical and clinical evaluations of a porous tantalum implant for the treatment of early-stage osteonecrosis. J Bone Joint Surg (Am), 2005, 87 Suppl 2: 22-27.
15.	Bobyn JD, Stackpool GJ, Hacking SA, et al. Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial. J Bone Joint Surg (Br), 1999, 81(5): 907-914.
16.	Wu SH, Li Y, Zhang YQ, et al. Porous titanium-6 aluminum-4 vanadium cage has better osseointegration and less micromotion than a poly-ether-ether-ketone cage in sheep vertebral fusion. Artif Organs, 2013, 37(12): E191-E201.
17.	Schlee M, van der Schoor WP, van der Schoor AR. Immediate loading of trabecular metal-enhanced titanium dental implants: interim results from an international proof-of-principle study. Clin Implant Dent Relat Res, 2015, 17 Suppl 1: e308-e320.
18.	Petite H, Viateau V, Bensaid W, et al. Tissue-engineered bone regeneration. Nat Biotechnol, 2000, 18(9): 959-963.
19.	Park JW, Kim ES, Jang JH, et al. Healing of rabbit calvarial bone defects using biphasic calcium phosphate ceramics made of submicron-sized grains with a hierarchical pore structure. Clin Oral Implants Res, 2010, 21(3): 268-276.
20.	Tokarski AT, Novack TA, Parvizi J. Is tantalum protective against infection in revision total hip arthroplasty? Bone Joint J, 2015, 97-B(1): 45-49.
21.	Wigfield C, Robertson J, Gill S, et al. Clinical experience with porous tantalum cervical interbody implants in a prospective randomized controlled trial. Br J Neurosurg, 2003, 17(5): 418-425.
22.	Barnes M, Ton L. Trabecular metal blocks for ACDF: Porous fusion or poor fusion? J Bone Joint Surg (Br), 2009, 91-B(SUPP III): 430-431.
23.	Schoettle T, Standard S, Lanford G, et al. Successful use of a modern porous tantalum (Trabecular Metal) device for cervical interbody fusion: results from a prospective, randomized multi-center clinical study. Spine, 2005, (7): 178-179.
24.	Fernández-Fairen M, Murcia A, Torres A, et al. Is anterior cervical fusion with a porous tantalum implant a cost-effective method to treat cervical disc disease with radiculopathy? Spine (Phila Pa 1976), 2012, 37(20): 1734-1741.
25.	Kasliwal MK, Baskin DS, Traynelis VC. Failure of porous tantalum cervical interbody fusion devices: two-year results from a prospective, randomized, multicenter clinical study. J Spinal Disord Tech, 2013, 26(5): 239-245.
26.	Löfgren H, Engquist M, Hoffmann P, et al. Clinical and radiological evaluation of Trabecular Metal and the Smith-Robinson technique in anterior cervical fusion for degenerative disease: a prospective, randomized, controlled study with 2-year follow-up. Eur Spine J, 2010, 19(3): 464-473.
27.	Matejka J, Zeman J, Belatka J. Mid-term results of 360-degree lumbar spondylodesis with the use of a tantalum implant for disc replacement. Acta Chir Orthop Traumatol Cech, 2009, 76(5): 388-393.
28.	Molloy S, Butler J, Yu H, et al. Clinical and radiologic outcome from 360-degree lumbar spondylodesis using porous tantalum cages in complex spinal reconstruction for degenerative lumbar spine deformity. Bone Joint J, 2014, 96-B: 15-26.
29.	Malloy JP, Peppelman W, Harris R, et al. Clinical outcomes with porous tantalum in lumbar interbody fusion. Spine J, 2010, 10(9): S147-S148.
30.	Høy K, Bünger C, Niederman B, et al. Transforaminal lumbar interbody fusion (TLIF) versus posterolateral instrumented fusion (PLF) in degenerative lumbar disorders: a randomized clinical trial with 2-year follow-up. Eur Spine J, 2013, 22(9): 2022-2029.
31.	Lequin MB, Verbaan D, Bouma GJ. Posterior lumbar interbody fusion with stand-alone Trabecular Metal cages for repeatedly recurrent lumbar disc herniation and back pain. J Neurosurg Spine, 2014, 20(6): 617-622.
32.	Miyazaki T, Kim HM, Miyaji F, et al. Bioactive tantalum metal prepared by NaOH treatment. J Biomed Mater Res, 2000, 50(1): 35-42.
33.	Barrère F, van der Valk CM, Meijer G, et al. Osteointegration of biomimetic apatite coating applied onto dense and porous metal implants in femurs of goats. J Biomed Mater Res B Appl Biomater, 2003, 67(1): 655-665.
34.	Sieber I, Mathan KB, Schmuki P. Self-assembled porous tantalum oxide prepared in H2SO4/HF electrolytes. Electrochemical and Solid-State Letters, 2005, 8(3): J10-J12.
35.	Guo X, Chen M, Feng W, et al. Electrostatic self-assembly of multilayer copolymeric membranes on the surface of porous tantalum implants for sustained release of doxorubicin. Int J Nanomedicine, 2011, 6: 3057-3064.

1. Kaplar RB, Hills B. Open cell tantalum structures for cancellous bone implants and cell and tissue receptors: US, 5282861[P]. 1994-02-01.
2. Levine BR, Sporer S, Poggie RA, et al. Experimental and clinical performance of porous tantalum in orthopedic surgery. Biomaterials, 2006, 27(27): 4671-4681.
3. Yang H, Li J, Zhou Z, et al. Structural preparation and biocompatibility evaluation of highly porous Tantalum scaffolds. Materials Letters, 2013, 100: 152-155.
4. Zhou Y, Zhu YC. Three-dimensional Ta foams produced by replication of NaCl space-holders. Materials Letters, 2013, 99: 8-10.
5. 李斌, 华永新, 杨光. 多孔钽金属的生物学特性: 近期临床应用安全但远期反应待证实. 中国组织工程研究, 2014, 18(43): 7028-7032.
6. 乔吉超, 奚正平, 汤慧萍, 等. 粉末冶金技术制备金属多孔材料研究进展. 稀有金属材料与工程, 2008, 37(11): 2054-2058.
7. Zhang Y, Ahn PB, Fitzpatrick DC, et al. Interfacial frictional behavior: cancellous bone, cortical bone, and a novel porous tantalum biomaterial. Journal of Musculoskeletal Research, 1999, 3(4): 245-251.
8. Matsuno H, Yokoyama A, Watari F, et al. Biocompatibility and osteogenesis of refractory metal implants, titanium, hafnium, niobium, tantalum and rhenium. Biomaterials, 2001, 22(11): 1253-1262.
9. Jonitz A, Lochner K, Lindner T, et al. Oxygen consumption, acidification and migration capacity of human primary osteoblasts within a three-dimensional tantalum scaffold. J Mater Sci Mate Med, 2011, 22(9): 2089-2095.
10. Hofstetter W, Sehr H, de Wild M, et al. Modulation of human osteoblasts by metal surface chemistry. J Biomed Mater Res A, 2013, 101(8): 2355-2364.
11. Sagomonyants KB, Hakim-Zargar M, Jhaveri A, et al. Porous tantalum stimulates the proliferation and osteogenesis of osteoblasts from elderly female patients. J Orthop Res, 2011, 29(4): 609-616.
12. Bergemann C, Klinkenberg ED, Lüthen F, et al. Proliferation and migration of human osteoblasts on porous three dimensional scaffolds. Materials Science Forum, 2010, 638-642: 506-511.
13. Unger AS, Lewis RJ, Gruen T. Evaluation of a porous tantalum uncemented acetabular cup in revision total hip arthroplasty: clinical and radiological results of 60 hips. J Arthroplasty, 2005, 20(8): 1002-1009.
14. Tsao AK, Roberson JR, Christie MJ, et al. Biomechanical and clinical evaluations of a porous tantalum implant for the treatment of early-stage osteonecrosis. J Bone Joint Surg (Am), 2005, 87 Suppl 2: 22-27.
15. Bobyn JD, Stackpool GJ, Hacking SA, et al. Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial. J Bone Joint Surg (Br), 1999, 81(5): 907-914.
16. Wu SH, Li Y, Zhang YQ, et al. Porous titanium-6 aluminum-4 vanadium cage has better osseointegration and less micromotion than a poly-ether-ether-ketone cage in sheep vertebral fusion. Artif Organs, 2013, 37(12): E191-E201.
17. Schlee M, van der Schoor WP, van der Schoor AR. Immediate loading of trabecular metal-enhanced titanium dental implants: interim results from an international proof-of-principle study. Clin Implant Dent Relat Res, 2015, 17 Suppl 1: e308-e320.
18. Petite H, Viateau V, Bensaid W, et al. Tissue-engineered bone regeneration. Nat Biotechnol, 2000, 18(9): 959-963.
19. Park JW, Kim ES, Jang JH, et al. Healing of rabbit calvarial bone defects using biphasic calcium phosphate ceramics made of submicron-sized grains with a hierarchical pore structure. Clin Oral Implants Res, 2010, 21(3): 268-276.
20. Tokarski AT, Novack TA, Parvizi J. Is tantalum protective against infection in revision total hip arthroplasty? Bone Joint J, 2015, 97-B(1): 45-49.
21. Wigfield C, Robertson J, Gill S, et al. Clinical experience with porous tantalum cervical interbody implants in a prospective randomized controlled trial. Br J Neurosurg, 2003, 17(5): 418-425.
22. Barnes M, Ton L. Trabecular metal blocks for ACDF: Porous fusion or poor fusion? J Bone Joint Surg (Br), 2009, 91-B(SUPP III): 430-431.
23. Schoettle T, Standard S, Lanford G, et al. Successful use of a modern porous tantalum (Trabecular Metal) device for cervical interbody fusion: results from a prospective, randomized multi-center clinical study. Spine, 2005, (7): 178-179.
24. Fernández-Fairen M, Murcia A, Torres A, et al. Is anterior cervical fusion with a porous tantalum implant a cost-effective method to treat cervical disc disease with radiculopathy? Spine (Phila Pa 1976), 2012, 37(20): 1734-1741.
25. Kasliwal MK, Baskin DS, Traynelis VC. Failure of porous tantalum cervical interbody fusion devices: two-year results from a prospective, randomized, multicenter clinical study. J Spinal Disord Tech, 2013, 26(5): 239-245.
26. Löfgren H, Engquist M, Hoffmann P, et al. Clinical and radiological evaluation of Trabecular Metal and the Smith-Robinson technique in anterior cervical fusion for degenerative disease: a prospective, randomized, controlled study with 2-year follow-up. Eur Spine J, 2010, 19(3): 464-473.
27. Matejka J, Zeman J, Belatka J. Mid-term results of 360-degree lumbar spondylodesis with the use of a tantalum implant for disc replacement. Acta Chir Orthop Traumatol Cech, 2009, 76(5): 388-393.
28. Molloy S, Butler J, Yu H, et al. Clinical and radiologic outcome from 360-degree lumbar spondylodesis using porous tantalum cages in complex spinal reconstruction for degenerative lumbar spine deformity. Bone Joint J, 2014, 96-B: 15-26.
29. Malloy JP, Peppelman W, Harris R, et al. Clinical outcomes with porous tantalum in lumbar interbody fusion. Spine J, 2010, 10(9): S147-S148.
30. Høy K, Bünger C, Niederman B, et al. Transforaminal lumbar interbody fusion (TLIF) versus posterolateral instrumented fusion (PLF) in degenerative lumbar disorders: a randomized clinical trial with 2-year follow-up. Eur Spine J, 2013, 22(9): 2022-2029.
31. Lequin MB, Verbaan D, Bouma GJ. Posterior lumbar interbody fusion with stand-alone Trabecular Metal cages for repeatedly recurrent lumbar disc herniation and back pain. J Neurosurg Spine, 2014, 20(6): 617-622.
32. Miyazaki T, Kim HM, Miyaji F, et al. Bioactive tantalum metal prepared by NaOH treatment. J Biomed Mater Res, 2000, 50(1): 35-42.
33. Barrère F, van der Valk CM, Meijer G, et al. Osteointegration of biomimetic apatite coating applied onto dense and porous metal implants in femurs of goats. J Biomed Mater Res B Appl Biomater, 2003, 67(1): 655-665.
34. Sieber I, Mathan KB, Schmuki P. Self-assembled porous tantalum oxide prepared in H2SO4/HF electrolytes. Electrochemical and Solid-State Letters, 2005, 8(3): J10-J12.
35. Guo X, Chen M, Feng W, et al. Electrostatic self-assembly of multilayer copolymeric membranes on the surface of porous tantalum implants for sustained release of doxorubicin. Int J Nanomedicine, 2011, 6: 3057-3064.

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Chinese Journal of Reparative and Reconstructive Surgery

PHYSICOCHEMICAL PROPERTIES AND BIOLOGICAL CHARACTERISTICS OF POROUS TANTALUM AND ITS APPLICATION PROGRESS IN SPINAL SURGERY

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