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Medium term clinical outcomes of tibial cones in revision knee arthroplasty

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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Submitted on : Thursday, February 18, 2021 - 3:27:15 PM
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Roger Erivan, Robert Tracey, Aurélien Mulliez, Guillaume Villatte, Wayne Paprosky. Medium term clinical outcomes of tibial cones in revision knee arthroplasty. Archives of Orthopaedic and Trauma Surgery, Springer Verlag, 2021, 141 (1), pp.113-118. ⟨10.1007/s00402-020-03532-1⟩. ⟨hal-03145693⟩



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