Can XXXX cones provide fixation in complex revision knee arthroplasty?

@entity1 @entity174 @entity604 @entity281 @entity3061 @entity158 @entity11608 @entity1349
BACKGROUND: The best method for managing large bone defects during revision knee arthroplasty is unknown. Metaphyseal fixation using porous @entity11608 cones has been proposed for severe @entity604 . Whether this approach achieves osseointegration with low complication rates is unclear. QUESTIONS/PURPOSES: We therefore asked: (1) What is the risk of @entity281 in revision knee arthroplasty with large bone defects reconstructed with porous @entity11608 cones? (2) What is the rate of osseointegration with these cones? (3) What is the rate of loosening and reoperation? (4) Is knee function restored? METHODS: We retrospectively reviewed 27 @entity1 who had 33 @entity11608 cones (nine femoral, 24 tibial) implanted during 27 revision knee arthroplasties. There were 14 @entity1 and 13 @entity1 with a mean age of 64.6 years. Preoperative diagnosis was reimplantation for @entity281 in 13 knees, @entity1349 in 10, and wear- @entity3061 in four. @entity1 were evaluated clinically and radiographically using the score systems of the Knee Society and followed for a minimum of 2 years (mean, 3.3 years; range, 2-5.7 years). RESULTS: One knee with two cones was removed for @entity281 . All but one cone showed osseointegration. One knee was revised for femoral cone and component loosening. There was one reoperation for femoral shaft @entity174 and one for superficial dehiscence. The mean Knee Society @entity158 score improved from 40 points preoperatively to 79 points postoperatively. The mean function score improved from 19 points to 47 points. CONCLUSIONS: Our observations suggest metaphyseal fixation with @entity11608 cones can be achieved. Longer-term followup is required to determine whether the fixation is durable.
