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Arch Orthop Trauma Surg · Mar 2023
Novel metaphyseal porous titanium cones allow favorable outcomes in revision total knee arthroplasty.
- Ittai Shichman, Christian Oakley, Jore H Willems, Gijs G van Hellemondt, Petra Heesterbeek, Joshua Rozell, Scott Marwin, and Ran Schwarzkopf.
- Division of Adult Reconstruction, Department of Orthopedic Surgery, NYU Langone Health, 301 East 17Th Street, New York, NY, 10003, USA.
- Arch Orthop Trauma Surg. 2023 Mar 1; 143 (3): 153715471537-1547.
IntroductionLoosening and migration are common modes of aseptic failure following complex revision total knee arthroplasty (rTKA). Metaphyseal cones allow surgeons to negotiate the loss of femoral and tibial bone stock while obtaining stable bony fixation. This study examines the mid-term functional and radiographic outcomes in patients undergoing rTKA utilizing a novel metaphyseal cone system with stems of variable length and fixation methods.MethodsThis two-center retrospective study examined all patients who underwent rTKA with a novel porous, titanium tibial or femoral cone in combination with a stem of variable length and fixation who had a minimum follow-up of 2-years. Outcome analysis was separated into tibial and femoral cones as well as the stem fixation method (hybrid vs. fully cemented).ResultsOverall, 123 patients who received 156 cone implants were included (74 [60.2%] tibial only, 16 [13.0%] femoral only, and 33 [26.8%] simultaneous tibial and femoral) with a mean follow-up of 2.76 ± 0.66 years. At 2-years of follow-up the total cohort demonstrated 94.3% freedom from all-cause re-revisions, 97.6% freedom from aseptic re-revisions, and 99.4% of radiographic cone osteointegration. All-cause revision rates did not differ between stem fixation techniques in both the tibial and femoral cone groups.ConclusionThe use of a novel porous titanium femoral and tibial metaphyseal cones combined with stems in patients with moderate to severe bone defects undergoing complex revision total knee arthroplasty confers excellent results independent of stem fixation technique.Level Of EvidenceIV, case series.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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