Three-Year Follow Up Utilizing Tantal Cones in Revision Total Knee Arthroplasty
Section snippets
Materials and Methods
This study was approved by the institutional review board. A total of 44 patients underwent revision knee arthroplasty procedures using TM cones to reconstruct tibial and/or femoral bone defects. From those 44 patients, 25 were females and 19 males with an average age of 72 years (range 44–85 years). The procedures were performed from 2007 to 2009 in our institution. At latest follow up, 38 patients remained in the study, five patients were lost to follow-up and one patient past away.
The 38
Results
The average preoperative flexion of the 38 patients was 84° (range 16° to 120°). At the time of latest follow-up at 37 month (range 35–42 month), the range of motion had improved to an average flexion of 100° (range 80° to 130°). Preoperatively, 4 patients had an extension lag of < 5°, 2 patients with 5-10° and one patient with a 15° extension lag. At the time of latest follow-up all 38 patients achieved full extension except one patient who had a residual extension lag of 5°.
According to the AORI
Discussion
Managing bone loss in revision total knee arthroplasty can be compounded by several challenges and pitfalls. Management of bone loss depends on the size and location of the deficit and the patient’s age, activity, and life expectancy.
TM cones are a valid option to the management of massive bone loss. These augments can provide structural support in patients for whom a custom prosthesis or large structural allograft would have been necessary 6., 8., 10., 11., 12., 13., 14., 15., 16., 17..
Highly
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The Cost-Effectiveness of Tibial Metaphyseal Cones in Revision Total Knee Arthroplasty
2022, Journal of ArthroplastyReconstruction of Proximal Metaphyseal Femoral Defects Using Trabecular Metal Augments in Revision Total Hip Arthroplasty
2021, Arthroplasty TodayCitation Excerpt :However, none of these strategies have completely eliminated problems with fixation in patients with severe loss of proximal femoral bone stock. Porous metal cones such as tantalum or titanium alloy constructs have been successfully used in revision arthroplasty [10,13,16,17]. The high coefficient of friction vs cancellous bone is responsible for its initial fixation [27].
Midterm Outcomes of Tantalum Metal Cones for Severe Bone Loss in Complex Primary and Revision Total Knee Arthroplasty
2021, Arthroplasty TodayCitation Excerpt :The intrinsic porous nature of the TM cone has been shown to have some resistance to bacterial adherence and infection compared with other materials [2,9,10]. Multiple studies have shown that TM cones provide stable fixation and rotational stability in the treatment of severe bone deficiencies in revision TKAs in the short-term with documented osteointegration [10-17]. However, a longer follow-up is needed to determine the durability of these reconstructions.
Other metallic alloys: Tantalum-based materials for biomedical applications
2021, Structural Biomaterials: Properties, Characteristics, and Selection
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.01.028.
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Hans-Christian R. Schmitz and Wolfgang Klauser contributed equally to this work.