BACKGROUND: The reconstruction of severe bone loss utilizing porous tantalum cones in patients undergoing revision total knee arthroplasty (TKA) has been established in the last years. However, reports on a long-term follow-up to assess the durability of such implants when combined with hinged knee designs are lacking. The current study aimed to evaluate the results of a previous study cohort at a minimum follow-up of 10 years. METHODS: A retrospective review was performed. The initial study cohort comprised of 38 patients who underwent aseptic revision TKA between 2007 and 2009 at a single institution. After exclusion of the deceased patients and patients who were lost to follow-up, 25 patients with hinged knees and 32 cones implanted were included with a minimum follow-up of 10 years (mean = 126.5 months, range 120-142, standard deviation [SD] = 5.92). Survivorship was determined, and re-revisions were observed. Functional Knee Society Score was assessed. RESULTS: After a minimum of 10 years, 24 of 32 cones (75%) had survived without any exchange in 18 patients. Reasons for cone revision included aseptic loosening (5/32 cones; 15.6%) and periprosthetic joint infection (3/32 cones; 9.4%). In 4 of the five revisions due to aseptic loosening, pure hinged knees had been implanted. The mean functional Knee Society Score of the survivors was 69.6 points (range 10-100, SD = 30.85), and the average flexion ability of the knee was 92° (range 30°-120°, SD = 22.09). CONCLUSION: Porous tantalum cones in revision TKA exhibited no favorable but reasonable long-term durability. Rotating-hinge designs should be used whenever possible to reduce the risk of aseptic loosening. Further comparative long-term analyses with other techniques or implants could inform us about the best treatment method.
BACKGROUND: The reconstruction of severe bone loss utilizing porous tantalum cones in patients undergoing revision total knee arthroplasty (TKA) has been established in the last years. However, reports on a long-term follow-up to assess the durability of such implants when combined with hinged knee designs are lacking. The current study aimed to evaluate the results of a previous study cohort at a minimum follow-up of 10 years. METHODS: A retrospective review was performed. The initial study cohort comprised of 38 patients who underwent aseptic revision TKA between 2007 and 2009 at a single institution. After exclusion of the deceased patients and patients who were lost to follow-up, 25 patients with hinged knees and 32 cones implanted were included with a minimum follow-up of 10 years (mean = 126.5 months, range 120-142, standard deviation [SD] = 5.92). Survivorship was determined, and re-revisions were observed. Functional Knee Society Score was assessed. RESULTS: After a minimum of 10 years, 24 of 32 cones (75%) had survived without any exchange in 18 patients. Reasons for cone revision included aseptic loosening (5/32 cones; 15.6%) and periprosthetic joint infection (3/32 cones; 9.4%). In 4 of the five revisions due to aseptic loosening, pure hinged knees had been implanted. The mean functional Knee Society Score of the survivors was 69.6 points (range 10-100, SD = 30.85), and the average flexion ability of the knee was 92° (range 30°-120°, SD = 22.09). CONCLUSION: Porous tantalum cones in revision TKA exhibited no favorable but reasonable long-term durability. Rotating-hinge designs should be used whenever possible to reduce the risk of aseptic loosening. Further comparative long-term analyses with other techniques or implants could inform us about the best treatment method.
Authors: Fabio Mancino; Vincenzo Di Matteo; Fabrizio Mocini; Silvia Pietramala; Alessandro Singlitico; Andrea De Fazio; Vincenzo La Vergata; Giorgio Gasparini; Giulio Maccauro; Ivan De Martino Journal: Orthop Rev (Pavia) Date: 2022-06-27
Authors: Kevin Deere; Michael R Whitehouse; Setor K Kunutsor; Adrian Sayers; Andrew J Price; James Mason; Ashley W Blom Journal: Lancet Rheumatol Date: 2021-04-29
Authors: Alexander A Cherny; Anton N Kovalenko; Taras A Kulyaba; Nikolai N Kornilov Journal: Arch Orthop Trauma Surg Date: 2021-07-15 Impact factor: 3.067