Highly Porous Metaphyseal Cones in Revision Total Knee Arthroplasty: A Case Series

Abstract Highly porous metaphyseal cones are used for the management of large bone defects in revision total knee arthroplasty. These cones fill defects and allow bony ongrowth while providing several sizing and offset options. In this case series, we evaluated three patients who received these latest generation metaphyseal cones. Specifically, these cases will be explored in detail with respect to history, indications, operative technique, and short-term outcomes. Overall, these newer generation porous coated cones are excellent options for large contained bone loss in the absence of infection, and they have demonstrated good clinical and radiological outcomes at short-term follow-up.

[1]  M. Chughtai,et al.  Tantalum Cones in Revision Total Knee Arthroplasty , 2016, Journal of Knee Surgery.

[2]  F. Haddad,et al.  The epidemiology of failure in total knee arthroplasty: avoiding your next revision. , 2016, The bone & joint journal.

[3]  M. Austin,et al.  Metaphyseal bone loss in revision knee arthroplasty , 2015, Current Reviews in Musculoskeletal Medicine.

[4]  B. Levine,et al.  The Use of Trabecular Metal Cones in Complex Primary and Revision Total Knee Arthroplasty. , 2015, The Journal of arthroplasty.

[5]  P. Sculco,et al.  Tantalum Cones Provide Durable Mid-term Fixation in Revision TKA , 2015, Clinical orthopaedics and related research.

[6]  A. Hanssen,et al.  Porous tantalum metaphyseal cones for severe tibial bone loss in revision knee arthroplasty: a five to nine-year follow-up. , 2015, The Journal of bone and joint surgery. American volume.

[7]  R. Bitsch,et al.  Treatment of severe bone defects during revision total knee arthroplasty with structural allografts and porous metal cones-a systematic review. , 2015, The Journal of arthroplasty.

[8]  H. Schrøder,et al.  Outcome of revision total knee arthroplasty with the use of trabecular metal cone for reconstruction of severe bone loss at the proximal tibia. , 2014, The Knee.

[9]  D. Kendoff,et al.  Three-year follow up utilizing tantal cones in revision total knee arthroplasty. , 2013, The Journal of arthroplasty.

[10]  A. Rıos-Luna,et al.  Tantalum cones in revision total knee arthroplasty. A promising short-term result with 29 cones in 21 patients. , 2013, The Journal of arthroplasty.

[11]  J. Hardes,et al.  Distal femur and proximal tibia replacement with megaprosthesis in revision knee arthroplasty: a limb-saving procedure , 2012, Knee Surgery, Sports Traumatology, Arthroscopy.

[12]  J. Howard,et al.  Early results of the use of tantalum femoral cones for revision total knee arthroplasty. , 2011, The Journal of bone and joint surgery. American volume.

[13]  G. Scuderi**,et al.  Porous tantalum cones for large metaphyseal tibial defects in revision total knee arthroplasty: a minimum 2-year follow-up. , 2009, The Journal of arthroplasty.

[14]  A. Hanssen,et al.  Limitations of Structural Allograft in Revision Total Knee Arthroplasty , 2009, Clinical orthopaedics and related research.

[15]  A. Hanssen,et al.  Use of porous tantalum metaphyseal cones for severe tibial bone loss during revision total knee replacement. , 2008, The Journal of bone and joint surgery. American volume.

[16]  S. Kurtz,et al.  Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. , 2007, The Journal of bone and joint surgery. American volume.

[17]  T. Vail,et al.  Management of bone loss in revision total knee arthroplasty. , 2006, Clinical orthopaedics and related research.

[18]  D. Backstein,et al.  Management of Bone Loss: Structural Grafts in Revision Total Knee Arthroplasty , 2006, Clinical orthopaedics and related research.

[19]  Gregory F. Carolan,et al.  Impaction Grafting for Bone Defects in Revision Total Knee Arthroplasty , 2006, Clinical orthopaedics and related research.

[20]  C. Ranawat,et al.  Bone graft for tibial defects in total knee arthroplasty. 1986. , 2006, Clinical orthopaedics and related research.

[21]  M. Ritter,et al.  Medial screws and cement: a possible mechanical augmentation in total knee arthroplasty. , 2004, The Journal of arthroplasty.

[22]  J. Lonner,et al.  Impaction Grafting and Wire Mesh for Uncontained Defects in Revision Knee Arthroplasty , 2002, Clinical orthopaedics and related research.

[23]  Brian S. Parsley,et al.  Morselized Bone Grafting of Defects in Revision Total Knee Arthroplasty , 2001, Clinical orthopaedics and related research.

[24]  K. Ogata,et al.  Bone Graft for Tibial Defects in Total Knee Arthroplasty , 2001 .

[25]  A. Gross,et al.  The Use of Structural Allograft for Uncontained Defects in Revision Total Knee Arthroplasty: A Minimum Five-Year Review , 2001, The Journal of bone and joint surgery. American volume.

[26]  D. Ammeen,et al.  Bone loss with revision total knee arthroplasty: defect classification and alternatives for reconstruction. , 1999, Instructional course lectures.