A prospective study on outcome of patient-specific cones in revision knee arthroplasty

Cherny, Alexander A.; Коваленко, А. Н.; Kulyaba, T.A.; Корнилов, Николай Николаевич

doi:10.1007/s00402-021-04047-z

Cited by 7 publications

(10 citation statements)

References 33 publications

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“…There were no LoE I and II studies available for inclusion. The studies included one prospective LoE III, 19 and six LoE IV studies according to Oxford Centre for Evidence-based Medicine Level of Evidence. 11, 13,15,16,18,20,21 Given the overall lack of level I and II studies, a meta-analysis was not conducted.…”

Section: Study Selectionmentioning

confidence: 99%

“…The mean follow-up was 24.2 months (range, 14-30 months). Six studies reported on the gender of the patients (543 patients) 11,13,15,16,19,20 including 298 females (54.9%) and 223 males (45.1%). Three studies (212 knees) reported on the mean number of surgical procedures before index revision 11,13,21 with a mean number of 2.5 (range, 1-4.2 procedures).…”

Section: Demographic Datamentioning

confidence: 99%

“…The metaphyseal portions of the implants were cemented to the internal surface of the metal cones in every case. Five studies (487 knees) reported the type of prosthetic implant used, 11,15,16,19,20 condylar constrained knee (CCK) implant was used in 61.8% of the revisions (301 knees), followed by a rotating hinge knee (RHK) in 22.8% of the cases (111 knees), and posterior stabilized knee (PS) in 13.9% (68 knees). Further details are addressed in Table 2.…”

Section: Demographic Datamentioning

confidence: 99%

“…Overall, 687 metal cones were implanted. All studies 11,13,15,16,[19][20][21] reported on 3D-printed titanium cones. Overall, 522 metal cones were used for tibial metaphyseal bone defects (75.9%), while 165 metal cones were used for femoral defects (24%).…”

Section: Conesmentioning

confidence: 99%

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Short-Term Survivorship of 3D-Printed Titanium Metaphyseal Cones in Revision Total Knee Arthroplasty: A Systematic Review.

et al. 2022

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Background Several studies have evaluated the outcomes of tantalum cones in revision knee arthroplasty with moderate-to-severe metaphyseal bone defects. However, recent innovations have led to the development of 3-D printed titanium cones to better adapt to host bone, there remains no consensus on their overall performance. Objective We therefore performed a systematic review of the literature to examine short-term survivorship and complication rates of their usage in revision TKAs. Methods A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews was conducted for English articles using various combinations of keywords. Results In all, 7 articles met the inclusion criteria. A total of 687 cones were implanted in 557 revision TKAs. The all-cause revision-free survivorship of the implants was 95.3% (26 revisions), and of the cones was 95.5% (31 cones revised) at mean 24 months follow-up. The cones revision-free survivorship from aseptic loosening was 99.7%. The overall complication rate was 19.7% with infection as the most common complications observed and the most frequent reason for revision with an incidence of 10.4% and 4.1%, respectively. Overall, functional outcomes improved as documented by postoperative knee scores. Conclusion 3-D printed metal cones represent a reliable option in metaphyseal bone defects reconstruction that provides high fixation, good short-term survivorship, and complications rates in line with similar devices. In addition, they are associated with lower intraoperative complications, and higher survivorship from aseptic loosening.

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Section: Study Selectionmentioning

confidence: 99%

Section: Demographic Datamentioning

confidence: 99%

Section: Demographic Datamentioning

confidence: 99%

Section: Conesmentioning

confidence: 99%

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Short-Term Survivorship of 3D-Printed Titanium Metaphyseal Cones in Revision Total Knee Arthroplasty: A Systematic Review.

et al. 2022

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“…Arthroplasty is an effective treatment for arthropathy, as it can relieve pain, restore physical activities, and improve the quality of life of patients. In prosthetic surgeries involving malignant bone tumors [ 1 ], revision arthroplasty [ 2 , 3 ], periprosthetic fractures, failed osteosynthesis [ 4 ], and infections, firm attachment between the tendon and the metal prosthesis is necessary to enhance motor function [ 5 , 6 ]. However, this challenge has not been solved because tendon tissue has poor vascularity and healing ability [ 7 , 8 ], and the biocompatibility of prostheses for tissue integration is generally poor.…”

Section: Introductionmentioning

confidence: 99%

Effect of Pore Size of Porous-Structured Titanium Implants on Tendon Ingrowth

Guo

Liu

Bian

et al. 2022

Applied Bionics and Biomechanics

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Purpose. The reconstruction of a tendon insertion on metal prostheses is a challenge in orthopedics. Of the available metal prostheses, porous metal prostheses have been shown to have better biocompatibility for tissue integration. Therefore, this study is aimed at identifying an appropriate porous structure for the reconstruction of a tendon insertion on metal prostheses. Methods. Ti6Al4V specimens with a diamond-like porous structure with triply periodic minimal surface pore sizes of 300, 500, and 700 μm and a porosity of 58% (designated Ti300, Ti500, and Ti700, respectively) were manufactured by selective laser melting and were characterized with micro-CT and scanning electron microscopy for their porosity, pore size, and surface topography. The porous specimens were implanted into the patellar tendon of rabbits. Tendon integration was evaluated after implantation into the tendon at 4, 8, and 12 weeks by histology, and the fixation strength was evaluated with a pull-out test at week 12. Results. The average pore sizes of the Ti300, Ti500, and Ti700 implants were 261, 480, and 668 μm, respectively. The Ti500 and Ti700 implants demonstrated better tissue growth than the Ti300 implant at weeks 4, 8, and 12. At week 12, the histological score of the Ti500 implant was 13.67 ± 0.58 , and it had an area percentage of type I collagen of 63.90 % ± 3.41 % ; both of these results were significantly higher than those for the Ti300 and Ti700 implants. The pull-out load at week 12 was also the highest in the Ti500 group. Conclusion. Ti6Al4V implants with a diamond-like porous structure with triply periodic minimal surface pore size of 500 μm are suitable for tendon integration.

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