Short-term Outcomes of 3D-Printed Titanium Metaphyseal Cones in Revision Total Knee Arthroplasty

Orthopedics ◽  
2020 ◽  
Author(s):  
Ethan A. Remily ◽  
Iciar M. Dávila Castrodad ◽  
Nequesha S. Mohamed ◽  
Wayne A. Wilkie ◽  
Margaret N. Kelemen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Short Term ◽  
3D Printed ◽  
Total Knee

Tantalum Cones in Revision Total Knee Arthroplasty. A Promising Short-Term Result With 29 Cones in 21 Patients

2013 ◽  
Vol 28 (6) ◽  
pp. 988-993 ◽  
Author(s):  
Manuel Villanueva-Martínez ◽  
Basilio De la Torre-Escudero ◽  
José M. Rojo-Manaute ◽  
Antonio Ríos-Luna ◽  
Francisco Chana-Rodriguez
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Term Result ◽  
Short Term ◽  
Short Term Result ◽  
Total Knee

scholarly journals Revision Total Knee Arthroplasty with Metaphyseal Sleeves without Stem: Short-Term Results

Joints ◽  
2017 ◽  
Vol 05 (04) ◽  
pp. 207-211 ◽  
Author(s):  
Giacomo Stefani ◽  
Valerio Mattiuzzo ◽  
Greta Prestini
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Study ◽  
Knee Arthroplasty ◽  
Bone Ingrowth ◽  
Womac Score ◽  
Revision Total Knee Arthroplasty ◽  
X Rays ◽  
Short Term ◽  
Total Knee ◽  
Baseline Values

Purpose The aim of this study was to evaluate the efficacy of revision total knee arthroplasty (TKA) with cementless metaphyseal sleeves without stems either in the femoral or tibial side or in both. Methods In this retrospective study, 51 patients (51 knees) operated in the period 2010 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. Forty-six were available for the study. Mean follow-up was 37 months. Knee Society score (KSS) (objective knee score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) were used as outcome scores and compared with baseline values. X-rays were also examined and compared with postoperative exams to evaluate the presence of loosening, radiolucent lines, and bone ingrowth. Satisfaction of the patients was also investigated using a linear scale from 1 to 10. Results KSS improved from 39 to 77 (p < 0.01); WOMAC score improved from 76 to 41 (p < 0.01). Twenty-four (52%) patients were satisfied, 15 (32%) were partially satisfied, and 7 (16%) were unsatisfied. ROM improved from 93 to 96 degrees (nonsignificant difference). X-rays showed no loosening of the implants, radiolucent lines in 4 patients (3 of them were asymptomatic) and bone ingrowth in 43 out of 46 patients. Conclusion In this short-term retrospective study, the use of sleeves without stem was a safe and effective procedure in revision TKA. We found a significant improvement in clinical results compared with baseline values and no signs of implant loosening. Level of Evidence Level IV, therapeutic case series.

scholarly journals Reconstruction for Massive Proximal Tibial Bone Defects Using Patient-customized Three-dimensional-printed Metaphyseal Cones in Revision Total Knee Arthroplasty

2020 ◽  
Author(s):  
Yang Li ◽  
Xinguang Wang ◽  
Hua Tian
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Three Dimensional ◽  
Bone Defects ◽  
Revision Total Knee Arthroplasty ◽  
3D Printed ◽  
Total Knee ◽  
The Mean ◽  
Highly Porous

Abstract Background: The reconstruction of massive bone defects is one of the main challenges in revision total knee arthroplasty (RTKA). Although several methods are available, each of them has its prominent shortcomings. The purpose of this study is to review the clinical outcomes of RTKA with massive proximal tibial bone defects using patient-customized three-dimensional (3D)-printed highly porous metaphyseal cones.Methods: We retrospectively reviewed seven RTKAs with Anderson Orthopaedic Research Institute (AORI) type III tibial defects using patient-customized 3D-printed highly porous metaphyseal cones, which have been performed at a single institution between 2016 and 2018. Results: The mean age at diagnosis of the patients was 68 years old (61-77). The mean length of follow-up was 25.3 months (19-36). At the latest follow-up, no aseptic loosening or prosthetic joint infection has been determined. The mean HSS increased from 49 (39-63) to 78 (70-83) (P<0.01); the mean WOMAC increased from 59 (46-73) to 26 (12-38) (P<0.01). All patients obtained the range of motion and mechanical alignment improvement postoperatively.Conclusion: The patient-customized 3D-printed metaphyseal cone could be a promising technique in addressing severe tibial defects in RTKA. Our study shows encouraging short-term clinical and radiological outcomes with no aseptic loosening, periprosthetic infection, or fracture. Nevertheless, further follow-up and the expansion of sample size are needed to demonstrate the advantage of this innovative technique fully.

Short Term Outcomes of Revision Total Knee Arthroplasty

2014 ◽  
Vol 29 (11) ◽  
pp. 2163-2166 ◽  
Author(s):  
James D. Dieterich ◽  
Adam C. Fields ◽  
Calin S. Moucha
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Short Term ◽  
Total Knee

Use of Stepped Porous Titanium Metaphyseal Sleeves for Tibial Defects in Revision Total Knee Arthroplasty: Short Term Results

2014 ◽  
Vol 29 (6) ◽  
pp. 1219-1224 ◽  
Author(s):  
Steven L. Barnett ◽  
Ryan R. Mayer ◽  
Joseph S. Gondusky ◽  
Leera Choi ◽  
Jay J. Patel ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Porous Titanium ◽  
Revision Total Knee Arthroplasty ◽  
Short Term ◽  
Total Knee

Excellent two-year survivorship of 3D-printed metaphyseal cones in revision total knee arthroplasty

2020 ◽  
Vol 102-B (6_Supple_A) ◽  
pp. 107-115 ◽  
Author(s):  
Matthew W. Tetreault ◽  
Kevin I. Perry ◽  
Mark W. Pagnano ◽  
Arlen D. Hanssen ◽  
Matthew P. Abdel
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Loss ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Severe Bone Loss ◽  
Implant Survivorship ◽  
History Of ◽  
3D Printed ◽  
Total Knee ◽  
The Mean

Aims Metaphyseal fixation during revision total knee arthroplasty (TKA) is important, but potentially difficult when using historical designs of cone. Material and manufacturing innovations have improved the size and shape of the cones which are available, and simplified the required bone preparation. In a large series, we assessed the implant survivorship, radiological results, and clinical outcomes of new porous 3D-printed titanium metaphyseal cones featuring a reamer-based system. Methods We reviewed 142 revision TKAs in 139 patients using 202 cones (134 tibial, 68 femoral) which were undertaken between 2015 and 2016. A total of 60 involved tibial and femoral cones. Most cones (149 of 202; 74%) were used for Type 2B or 3 bone loss. The mean age of the patients was 66 years (44 to 88), and 76 (55 %) were female. The mean body mass index (BMI) was 34 kg/m2 (18 to 60). The patients had a mean of 2.4 (1 to 8) previous operations on the knee, and 68 (48%) had a history of prosthetic infection. The mean follow-up was 2.4 years (2 to 3.6). Results Survivorship free of cone revision for aseptic loosening was 100% and survivorship free of any cone revision was 98%. Survivorships free of any revision and any reoperation were 90% and 83%, respectively. Five cones were revised: three for infection, one for periprosthetic fracture, and one for aseptic tibial loosening. Radiologically, three unrevised femoral cones appeared loose in the presence of hinged implants, while the remaining cones appeared stable. All cases of cone loosening occurred in patients with Type 2B or 3 defects. The mean Knee Society score (KSS) improved significantly from 50 (0 to 94) preoperatively to 87 (72 to 94) (p < 0.001). Three intraoperative fractures with cone impaction (two femoral, one tibial) healed uneventfully. Conclusion Novel 3D-printed titanium cones, with a reamer-based system, yielded excellent early survivorship and few complications in patients with severe bone loss undergoing difficult revision TKA. The diversity of cone options, relative ease of preparation, and outcomes rivalling those of previous designs of cone support their continued use. Cite this article: Bone Joint J 2020;102-B(6 Supple A):107–115.

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