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

Tantalum Cones Provide Durable Mid-term Fixation in Revision TKA

“…However, if we take into consideration only the reoperations for infection and aseptic loosening of the cone, our revision frequency was in line with the reoperation frequencies reported by Meneghini et al [26] (two of 15) and Lachiewicz et al [23] (two of 27), although it was higher than reported by Howard et al [18] (0 of 24). Other studies reported reoperation rates similar to ours, between 5% and 14% [9,21,24,[34][35][36]42]. However, in those cohorts cones also were used to reconstruct less-severe defects (AORI Type 2A).…”

“…Cemented stems were used sporadically during the study period by the senior author in selected patients with wide intramedullary canals and poor bone stock. Third, the patient cohort was relatively small but similar in size to cohorts in previous reports [9,18,21,23,24,26,[34][35][36]42]. Even so, with small series, it is impossible to detect uncommon complications and lower-frequency events that might be clinically important.…”

“…Complications with these techniques include infection, graft resorption, nonunion, failure of graft incorporation, concerns regarding disease transmission, aseptic loosening, and periprosthetic fracture [1,7,14,17,33]. Although the short-term results with tantalum cones have been promising [9,18,21,23,24,26,[34][35][36]42], to our knowledge, there have been no studies reporting mid-term outcomes with their use. We therefore sought to determine the midterm results evaluating (1) reoperation rates for septic and aseptic causes, (2) radiologic findings of osseointegration, and (3) clinical outcomes based on the Knee Society score in patients who underwent revision knee arthroplasty with tantalum cones for significant bone loss.…”

“…Cone-shaped porous tantalum augments have been proposed as an alternative method to reconstruct severe bone defects during revision knee arthroplasty [9,18,21,23,24,26,[34][35][36]42]. Porous tantalum is widely used in total hip reconstruction [4], especially for treatment of severe acetabular bone loss during revision hip arthroplasty [4,5,30,37,41].…”

“…High volumetric porosity (average 80%), fully interconnected pores, and a low modulus of elasticity (3 GPa) similar to cancellous bone all enhance the potential for bone ingrowth and allow for a more physiologic load transfer with diminished stress shielding [3,8]. Multiple studies have shown that tantalum cones provide stable fixation in the treatment of severe bone deficiencies in total knee revision during the short-term with documented osseointegration [9,18,21,23,24,26,[34][35][36]42], however, longer-term followup is needed to determine the durability of these reconstructions.…”