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Medium term clinical outcomes of tibial cones in revision knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Trabecular metal cones are a relatively new option for reconstruction of major bone defects during revision total knee arthroplasty (TKA). The purpose of the present study was to retrospectively assess medium-term results for tibial cones in revision TKA with a severe proximal tibial bone defect. We hypothesized that revision TKA patients with bone defects treated with trabecular metal cones have excellent medium-term clinical and radiological results.

Patients and methods

A single-center retrospective review included all consecutive cases of tibial revision using trabecular metal cones. All patients with a minimum 2-year follow-up were included in the study. There were no exclusion criteria. The primary endpoint was tibial cone survivorship. The secondary endpoints were revision TKA all-cause survivorship, patient-reported outcome measures with a Knee injury and Osteoarthritis Outcome Score (KOOS), SF 12, and radiographic analysis.

Results

Five of the 57 patients alive at last follow-up (8.77%) had undergone revision (4 for infection and 1 for instability). Complications comprised four cases (7.02%) of infection, 2 cases (3.51%) of tibial and femoral implant aseptic loosening that did not require revision surgery, 1 of which (1.75%) with associated patellar loosening, and 1 case (1.75%) of instability. Kaplan–Meier estimates showed 100% 5-year survivorship with tibial cone revision for aseptic loosening and 93.44% (95% CI 83.47–97.49%) for all-cause revision.

Discussion

The present study of cones used for tibial revision supports shows excellent results; however, longer and larger follow-up is needed to better assess results in revision TKA.

Level of evidence

4, retrospective study

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Authors and Affiliations

  1. CNRS, SIGMA Clermont, ICCF, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France

    Roger Erivan & Guillaume Villatte

  2. Rush University, Chicago, IL, USA

    Robert Tracey & Wayne Paprosky

  3. Central DuPage Hospital, Northwestern University, Evanston, IL, USA

    Robert Tracey & Wayne Paprosky

  4. Délégation à la Recherche Clinique et aux Innovations (DRCI), CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France

    Aurélien Mulliez

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  1. Roger Erivan
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  2. Robert Tracey
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  3. Aurélien Mulliez
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  4. Guillaume Villatte
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Correspondence to Roger Erivan.

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RE: none; RT: none; AM: none; WP: consultancy fees and speaker fees from Zimmer-Biomet, Stryker, Intellijoint and Medtronic.

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Erivan, R., Tracey, R., Mulliez, A. et al. Medium term clinical outcomes of tibial cones in revision knee arthroplasty. Arch Orthop Trauma Surg 141, 113–118 (2021). https://doi.org/10.1007/s00402-020-03532-1

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