Setting the standard for acetabular reconstruction
Breaking the Revision Cycle
The Zimmer Biomet Trabecular Metal Acetabular Revision System (TMARS) combines clinically proven Trabecular Metal Technology1–3 with the ability to tailor individualized solutions for each patient. From simple to complex revision arthroplasty, this combination sets the standards for acetabular reconstruction.
- Revision Hip
An algorithmic approach to complex revisions
Survivorship at 10 years when a TM Revision Shell is used in revision THA.4
The TMARS system consists of the following acetabular and auxiliary implant designs:
Trabecular Metal Revision Shells and Liners
Designed for use in revision and primary cases. A one-piece construct, created by cementing the liner into the shell, eliminates concerns about backside wear. The low modulus of elasticity of the Trabecular Metal material can produce more normal physiological loading and reduce stress shielding.5
Trabecular Metal Cup Cage
Used in conjunction with the Trabecular Metal Revision Shell to provide adequate stability by spanning acetabular defects and pelvic discontinuities to provide initial mechanical stability of the Cup-Cage construct until biological fixation occurs. Cementing the Longevity Highly Crosslinked Polyethylene Liners, Cages, and Trabecular Metal Revision Shells together creates a single construct, without concerns of micromotion.6
Trabecular Metal Buttress and Shims
- Work with the revision shell to address extensive superior segmental defects (Paprosky Type IIIA).
- Serves as an alternative to allograft, without potential for bone resorption or disease transmission.
- Creates a monolithic construct without concerns for micromotion by using cemented interfaces.6
- Conserves host bone while implant size, position, and orientation are determined by the defect.
Trabecular Metal Augments and Restrictors
The Trabecular Metal Acetabular Augments and Restrictors fill bone deficiencies as an alternative to preparing and using structural grafts.7
With 100% open, interconnected pore structure, designed to support bony in-growth and vascularization.8
Shims placed between the buttress augment flange and host bone optimize the fit of the device against iliac bone conserving host bone and providing structural support.
Cages can be contoured to fit the acetabulum while providing mechanical stability.
Restrictors and augments come in many sizes supporting coverage of defects.
Revision shells feature multiple hole options to support the system
- Proven technology and fixation
Addresses Range of Deformities
- Designed to fit Paprosky Type I to IV acetabular deformities, enabling an algorithmic approach to challenging revisions.9
Lower Infection Rates
- Trabecular Metal (TM) acetabular components used in revision THA are associated with decreased rates of re-revision for infection compared to non-TM components as reported by Tokarski et al.10
Bactisure Wound Lavage™
Bactisure Wound Lavage is used to remove debris, including microorganisms, from wounds using pulsed (jet) lavage. The clear, colorless, low-odor solution is a FDA 510(K) cleared device. Active ingredients include ethanol (solvent), acetic acid (pH modifier), sodium acetate (buffer), benzalkonium chloride (surfactant), and water. Bactisure Wound Lavage is available in sterile 1000 mL polypropylene plastic bags with an integrated single spike port.
Trabecular Metal™ Acetabular Revision System (TMARS) Surgical Demonstration
- Lakstein, D. et al. Trabecular Metal Cups for Acetabular
Defects with 50% or Less Host Bone Contact. Clinical Orthopedics and
Related Research. 467(9):2318-24, 2009.
- Nakashima. et al. Clinical and Radiographic Evaluation of Total Hip Arthroplasties using Porous Tantalum Modular Acetabular Components: 5-year Follow-up of Clinical Trial. Modern Rheumatology. 23(1):112-8, 2013.
- Simon, J. and and Bellmans, J. Clinical and Radiological Evaluation of Modular Trabecular Metal Acetabular Cups Short-term Results in 64 Hips. Acta Orthopaedica (Belg). 75:623-30, 2009.
- Sousa, P. et al. Uncemented Highly
Porous Tantalum Acetabular Components: What is the Risk of Failure
10 Years After Revision Total Hip. Paper 541. AAOS 2018 Annual
- Pedersen DR, Brown TD, Poggie RA. Finite
element analysis of periarticular stress of cemented, metal-backed,
and porous tantalum backed acetabular components. 45th
Annual Orthopaedic Research Society Meeting, Anaheim, CA.
- Taylor, E and Browne, J. Reconstruction
Options for Acetabular Revision. Would Journal of Orthopedics.
- Nehme, A. et al. Modular
Porous Metal Augments for Treatment of Severe Acetabular Bone Loss
During Revision Hip Arthroplasty. Clinical Orthopaedics and Related
Research. 429:201-8, 2004.
- Karageorgious, V. et
al., Porosity of 3D Biomaterial Scaffolds and Osteogenesis.
Biomaterials, 27 (27): 5474–91, Sep. 2005.
SH, et al., The Use of Tantalum Porous Metal Implants
for Paprosky Type 3A and 3B Implants, Journal of Arthroplasty.
22(6): 151-155, 2007.
- Tokarski, AT. et al. Is tantalum protective against infection in revision total hip arthroplasty? Bone Joint J 2015;97-B:45–9.
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