title: [The use of tantalum cones for reconstruction of bone defects in revision total knee arthroplasty].
abstract: OBJECTIVE
  Revision arthroplasty of the knee is often associated with substantial femoral and/or tibial bone loss. Tantalum cones are used to reconstruct these defects and to improve initial stability. This requires an implantation in the "press-fit" technique with maximum contact to the host bone.
  
  
  METHODS
  Tantalum cones may be used in grade 2-3 femoral and/or tibial defects according to the AORI (Anderson Orthopedic Research Institute) classification system.
  
  
  METHODS
  There are no contraindications described.
  
  
  METHODS
  After removal of the implant and cement remnants, bone defects have to be evaluated. A tantalum cone which adequately fills the bone defect is implanted using the "press-fit" technique. If necessary, saving resection of surplus bone to fit the cone properly. Gaps between the cone and the host bone are filled with cancellous bone in "impaction-bone-grafting" technique to increase the area of contact. Fitting the revision knee prosthesis and fixing with the use of bone cement.
  
  
  METHODS
  Postoperative physiotherapy is adjusted to the result of the reconstruction. In most cases with stable reconstruction, mobilization with full weight-bearing and the use of two crutches can be performed. Additional bone grafting may require a partial weight-bearing regimen for postoperative mobilization. Physiotherapy to improve range of motion is performed starting on postoperative day 1.
  
  
  RESULTS
  Several studies reported promising midterm results (observation period about 36 months) after implantation of tantalum cones in revision knee arthroplasty. There is consistent evidence for stable osteointegration of the cones. The main intraoperative complication is fracture of the host bone during impaction of the cones.
authors: Abteilung für Gelenkchirurgie, HELIOS ENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Deutschland, matthias.gebauer@helios-kliniken.de.
authors: M
authors: M
authors: Gebauer
authors: T
authors: T
authors: Gehrke
authors: O
authors: O
authors: Jakobs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000295:instrumentation*; D001843:Bone Cements / Q000627:therapeutic use; D016025:Bone Transplantation / Q000295:instrumentation / Q000379:methods; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology / Q000601:surgery*; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D013635:Tantalum; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements; D013635:Tantalum
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