Fusion Rates in Tibiotalocalcaneal Arthrodesis with Tantalum-Coated Metal Cone Augmentation.

Abstract

Tantalum-coated metal spacers (TCMS) have been increasingly utilized to fill and provide structure to large bony defects in the hindfoot. There is a paucity of literature assessing the outcomes of tantalum-coated metal spacers in foot and ankle surgery. This study serves to assess clinical outcomes and fusion rates of patients who underwent tibiotalocalcaneal arthrodesis with tantalum augmentation. This is a retrospective cohort study (N = 65) of patients who underwent tibiotalocalcaneal arthrodesis with and without TCMS at a tertiary care center between 2015-2021. Computed tomography scans at the six-month postoperative point were reviewed to determine fusion status. Patient-reported outcomes measures were collected after at least 1 year postoperatively. A multivariate logistic regression model was used to measure the likelihood of achieving fusion with tantalum augmentation. There was a statistically significant lower rate of hardware failure in the TCMS group (4.76% vs. 34.09%, p = 0.021). TCMS-augmentation was a nonsignificant predictor of increased odds of fusion at the six-month postoperative point (OR = 4.84, p = 0.124). This study is the largest to date to present 6-month postoperative CT scans demonstrating successful tibiotalocalcaneal arthrodesis fusion with tantalum augmentation, contributing to our understanding of its utility. Further studies are needed to evaluate the efficacy of TCMS-augmented fusions as a viable substitute to custom printed cages. Level 3.