Anatomical 3D-printed metaphyseal cone in revision total knee arthroplasty: A short-term clinical and radiological follow-up evaluation.
prospective_cohort · Level II
Where this comes from
- Record sourced from PubMed, PMID 42305895.
- Also identified by DOI 10.1002/jeo2.70754 and PMC identifier 13266273.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Bone loss is commonly encountered during revision total knee arthroplasty (R-TKA), and metaphyseal cones are often used to address these defects. In addition, they can enhance Zone 2 fixation in R-TKA in the presence of poor bone quality. The aim of this study was to evaluate the short-term clinical and radiological outcomes of a novel three-dimensional (3D)-printed metaphyseal cone in R-TKA. This single-centre, single-surgeon prospective study included all patients who underwent R-TKA using a novel 3D-printed anatomical metaphyseal cone (AMF, ENOVIS®) with a minimum follow-up of 24 months. Patient demographics and operative details were recorded. Postoperative assessments included the Knee Society Score (KSS), Oxford Knee Score (OKS) and Short Form-12 (SF-12). Radiographic evaluation focused on radiolucent lines, implant or cone loosening and the cone's ability to replicate proximal tibial anatomy. Complications, reoperations and revisions for any reason were documented. Thirty patients (31 knees) underwent R-TKA with a total of 48 cones (24 tibial and 24 femoral), with a mean follow-up of 37.3 months (standard deviation [SD] 8.8). In 48.4% of cases, cones were used on both the tibial and femoral sides. No intraoperative fractures occurred during cone preparation. All patients demonstrated significant improvement in clinical outcomes. Radiographic evaluation showed no evidence of cone loosening and accurate reproduction of proximal tibial anatomy. Survivorship free from cone revision, including for aseptic loosening, was 100%. Survivorship free from any revision or reoperation was also 100%. This novel 3D-printed anatomical metaphyseal cone demonstrated excellent short-term outcomes, with no early loosening and accurate replication of proximal tibial morphology. However, longer-term follow-up and a larger cohort are required to confirm these preliminary findings. Level IV.