Porous Tantalum Cones for Large Metaphyseal Tibial Defects in Revision Total Knee Arthroplasty: A Minimum 2-Year Follow-up☆
Section snippets
Materials and Methods
Institutional review board approval was obtained for this retrospective review. All patients undergoing revision knee reconstruction for any reason, which required the use of a porous tantalum cone for tibial reconstruction (Fig. 1), were included in this study. All cases were performed by the senior surgeon. These cases represent a consecutive series of patients as porous tantalum cones were used for all cases when massive tibial defects were encountered. In no cases were other techniques such
Demographics
Sixteen revision procedures were performed on 15 patients. Average patient age at surgery was 66.1 years (range, 48-83 years). There were 8 females (1 case bilateral) and 7 males. Seven cases involved left knees and 9 right knees. The diagnosis was aseptic loosening in 13 cases and staged reimplantation after infection in 3 cases.
Surgical Data
Approaches included 15 medial parapatellar and 1 midline (associated with the extensor allograft). A quadriceps snip was required in 5 cases, and in 2 of those, a
Discussion
Large tibial bone defects present a challenging reconstructive problem. Traditionally, lesions have been treated with bone in the form of bulk allograft or impaction grafting 3, 4, 5, 6, 7, 8, 9, 10, modular tumor or custom components 11, 12, or allograft-prosthesis composites 13, 14. All of these techniques have been shown to be durable in midterm outcomes, but concerns exist for a number of reasons, including disease transmission; resorption, fracture, or immune reaction to allograft; the
Acknowledgment
The authors would like to acknowledge the assistance of Dr Henrik Bo Pedersen in manuscript and figure preparation.
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Tantalum Cones for Severe Bone Defects in Revision Knee Arthroplasty: A Minimum 10-Year Follow-Up
2023, Journal of ArthroplastyCitation Excerpt :In 12 cases, (60%) no pain was reported during walking or normal activities of daily living, in 3 cases (15%) was reported a mild-occasional pain, in 3 cases (15%) a mild pain that required analgesics to be controlled and in 2 cases (10%) a moderate pain during walking more than 100 meters not always controlled with analgesics. Porous tantalum cones have been widely considered a valid option in the management of severe bone loss in revision TKA, supported by numerous studies with promising 2- to 6-year (mean, 3.5 years) results [16–21,25–31,40]. Byttebier et al [41], recently performed of a metaanalysis the outcomes of different reconstruction options in revision TKA reporting a mid-term survivorship (5 to 10 years) of 546 porous metal cones of 89%.
The Cost-Effectiveness of Tibial Metaphyseal Cones in Revision Total Knee Arthroplasty
2022, Journal of ArthroplastySurvivorship of Metaphyseal Cones and Sleeves in Revision Total Knee Arthroplasty
2022, Journal of Arthroplasty
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One of the authors is a consultant for Zimmer Inc. Implex, Warsaw, IN, USA.