title: Total knee arthroplasty revision with trabecular tantalum cones: Preliminary retrospective study of 51 patients from two centres with a minimal 2-year follow-up.
abstract: Successful management of large bone defects is of crucial importance when performing revision total knee arthroplasty (TKA). Trabecular tantalum cones may improve prosthesis fixation via their potential for reconstructing a stable metaphyseal support. The objective of this study was to evaluate the clinical and radiological outcomes and the complications of tantalum cones in revision TKA.
  
  
  
  Trabecular tantalum cones provide stable and durable metaphyseal reconstruction when used during revision TKA.
  
  
  
  Trabecular Metal™ cones (Zimmer, Warsaw, IN, USA) were used for 52 revision TKAs in 51 patients (mean age, 68±9 years) managed in two centres between 2008 and 2013. A rotating hinge prosthesis was chosen for 38 (73%) knees and a condylar constrained knee prosthesis for 14 (27%) knees, with 37 tibial and 34 femoral cones. The two most common reasons for revision surgery were aseptic loosening (n=22, 42%) and infection (n=19, 37%). The bone loss was severe in most cases. At each centre, after a mean follow-up of 34 months (range, 24-52 months), two independent observers assessed the Knee Society Score (KSS), range of motion, mechanical axis, and osteo-integration for each patient.
  
  
  
  Mean KSS increased from 46 preoperatively to 77 (P=0.001) at last follow-up and the mean KSS function from 39 to 57 (P=0.007). Mean range of motion improved from 93° (45°-120°) to 110° (65°-130°) (P=0.001). Mean postoperative mechanical axis was 180° (172°-190°). Radiographic evaluation showed evidence of osteo-integration for all cones. Four revisions were performed for recurrence of infection but none for mechanical failure.
  
  
  
  The findings of our study confirm the biomechanical and biological reliability of Trabecular Metal™ cones used to fill metaphyseal bone defects during revision TKA.
  
  
  
  IV, retrospective therapeutic study.
authors.affiliation: Université Aix-Marseille, Hôpital Sainte-Marguerite, Institut du Mouvement et de l'appareil Locomoteur, Service de chirurgie orthopédique et traumatologie, UMR CNRS 787/AMU, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
authors.forename: D
authors.initials: D
authors.lastname: Girerd
authors.affiliation: Université Aix-Marseille, Hôpital Sainte-Marguerite, Institut du Mouvement et de l'appareil Locomoteur, Service de chirurgie orthopédique et traumatologie, UMR CNRS 787/AMU, 270, boulevard Sainte-Marguerite, 13009 Marseille, France. Electronic address: sebastien@parratte.fr.
authors.forename: S
authors.initials: S
authors.lastname: Parratte
authors.affiliation: Université Aix-Marseille, Hôpital Sainte-Marguerite, Institut du Mouvement et de l'appareil Locomoteur, Service de chirurgie orthopédique et traumatologie, UMR CNRS 787/AMU, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
authors.forename: A
authors.initials: A
authors.lastname: Lunebourg
authors.affiliation: Centre Hospitalier Régional Universitaire, Service de chirurgie orthopédique et traumatologie, avenue Oscar-Lambret, 59037 Lille cedex, France; Université de Lille, rue Paul-Duez, 59000 Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Boureau
authors.affiliation: Université Aix-Marseille, Hôpital Sainte-Marguerite, Institut du Mouvement et de l'appareil Locomoteur, Service de chirurgie orthopédique et traumatologie, UMR CNRS 787/AMU, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Ollivier
authors.affiliation: Centre Hospitalier Régional Universitaire, Service de chirurgie orthopédique et traumatologie, avenue Oscar-Lambret, 59037 Lille cedex, France; Université de Lille, rue Paul-Duez, 59000 Lille, France.
authors.forename: G
authors.initials: G
authors.lastname: Pasquier
authors.affiliation: Centre Hospitalier Régional Universitaire, Service de chirurgie orthopédique et traumatologie, avenue Oscar-Lambret, 59037 Lille cedex, France; Université de Lille, rue Paul-Duez, 59000 Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Putman
authors.affiliation: Centre Hospitalier Régional Universitaire, Service de chirurgie orthopédique et traumatologie, avenue Oscar-Lambret, 59037 Lille cedex, France; Université de Lille, rue Paul-Duez, 59000 Lille, France.
authors.forename: H
authors.initials: H
authors.lastname: Migaud
authors.affiliation: Université Aix-Marseille, Hôpital Sainte-Marguerite, Institut du Mouvement et de l'appareil Locomoteur, Service de chirurgie orthopédique et traumatologie, UMR CNRS 787/AMU, 270, boulevard Sainte-Marguerite, 13009 Marseille, France.
authors.forename: J N
authors.initials: JN
authors.lastname: Argenson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011474:Prosthesis Design; D012008:Recurrence; D012086:Reoperation / Q000295:instrumentation* / Q000379:methods; D012189:Retrospective Studies; D013635:Tantalum; D016896:Treatment Outcome
chemical_list: D013635:Tantalum
keywords: Bone defect; Knee; Revision; Tantalum; Total knee arthroplasty; Trabecular metal cones