• Roger Erivan, Robert Tracey, Aurélien Mulliez, Guillaume Villatte, and Wayne Paprosky.
• CNRS, SIGMA Clermont, ICCF, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France. rerivan@chu-clermontferrand.fr.
• Arch Orthop Trauma Surg. 2021 Jan 1; 141 (1): 113-118.

IntroductionTrabecular 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 MethodsA 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.ResultsFive 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.DiscussionThe 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 Evidence4, retrospective study.

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