Metaphyseal Fixation in Revision Total Knee Arthroplasty.

Megaloikonomos, Panayiotis D; AlShehri, Yasir; Garbuz, Donald S; Howard, Lisa C; Neufeld, Michael E; Masri, Bassam A · J Bone Joint Surg Am · 2025

review · Level V

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Abstract

➢ Bone defect management is challenging, but essential, in revision total knee arthroplasty.➢ Appropriate metaphyseal fixation is crucial for stability and implant support.➢ Allografts have been traditionally used to address large defects, but the advent of highly porous metaphyseal cones and sleeves has attracted attention during the past years.➢ Metaphyseal implants are now available in a variety of shapes and sizes to meet various clinical needs.➢ These devices can successfully fill large defects, can better support revision implants, and can achieve long-term biologic fixation.➢ Very good intermediate-term outcomes have been reported with the available metaphyseal implants, using fully cemented or press-fit stems.➢ More research is warranted to further assess surgical indications and the strengths and weaknesses of the various implants used for metaphyseal fixation.

Medical subject headings

Anatomy