Retaining a Well-fixed Cone During Revision Total Knee Arthroplasty: Surgical Technique and Outcomes

Metaphyseal cones are frequently used in revision total knee arthroplasties (TKAs). However, during subsequent aseptic re-revisions, removing a well-fixed cone can be difficult. One innovative option is to retain the well-fixed cone and cement a new, stemmed revision component through the retained c...

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Main Authors: Xiao T. Chen, MD, Michael W. Seward, MD, Robert T. Trousdale, MD, David G. Lewallen, MD, Matthew P. Abdel, MD, Nicholas A. Bedard, MD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352344124001626
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author Xiao T. Chen, MD
Michael W. Seward, MD
Robert T. Trousdale, MD
David G. Lewallen, MD
Matthew P. Abdel, MD
Nicholas A. Bedard, MD
author_facet Xiao T. Chen, MD
Michael W. Seward, MD
Robert T. Trousdale, MD
David G. Lewallen, MD
Matthew P. Abdel, MD
Nicholas A. Bedard, MD
author_sort Xiao T. Chen, MD
collection DOAJ
description Metaphyseal cones are frequently used in revision total knee arthroplasties (TKAs). However, during subsequent aseptic re-revisions, removing a well-fixed cone can be difficult. One innovative option is to retain the well-fixed cone and cement a new, stemmed revision component through the retained cone, yet minimal data exist on this technique. We describe a technique for retaining a well-fixed cone during re-revision TKA and report outcomes in 6 patients with 6 well-fixed metaphyseal cones. At a mean of 4 years follow-up, no retained cones with a new femoral or tibial component with stems were revised and there was no radiographic evidence of aseptic loosening. These early data suggest that retaining a well-fixed cone can be safe in re-revision TKA to minimize morbidity associated with cone removal. Level of evidence: IV (retrospective study).
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series Arthroplasty Today
spelling doaj-art-1a8f29648e384a4499ccaa1f8612ffaf2025-08-20T01:58:33ZengElsevierArthroplasty Today2352-34412024-12-013010147710.1016/j.artd.2024.101477Retaining a Well-fixed Cone During Revision Total Knee Arthroplasty: Surgical Technique and OutcomesXiao T. Chen, MD0Michael W. Seward, MD1Robert T. Trousdale, MD2David G. Lewallen, MD3Matthew P. Abdel, MD4Nicholas A. Bedard, MD5Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USADepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USADepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USADepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USADepartment of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USACorresponding author. Department of Orthopaedic Surgery, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55902, USA. Tel.: +1 507 284 5278.; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USAMetaphyseal cones are frequently used in revision total knee arthroplasties (TKAs). However, during subsequent aseptic re-revisions, removing a well-fixed cone can be difficult. One innovative option is to retain the well-fixed cone and cement a new, stemmed revision component through the retained cone, yet minimal data exist on this technique. We describe a technique for retaining a well-fixed cone during re-revision TKA and report outcomes in 6 patients with 6 well-fixed metaphyseal cones. At a mean of 4 years follow-up, no retained cones with a new femoral or tibial component with stems were revised and there was no radiographic evidence of aseptic loosening. These early data suggest that retaining a well-fixed cone can be safe in re-revision TKA to minimize morbidity associated with cone removal. Level of evidence: IV (retrospective study).http://www.sciencedirect.com/science/article/pii/S2352344124001626Metaphyseal conesAseptic revisionRevision total knee arthroplasty
spellingShingle Xiao T. Chen, MD
Michael W. Seward, MD
Robert T. Trousdale, MD
David G. Lewallen, MD
Matthew P. Abdel, MD
Nicholas A. Bedard, MD
Retaining a Well-fixed Cone During Revision Total Knee Arthroplasty: Surgical Technique and Outcomes
Arthroplasty Today
Metaphyseal cones
Aseptic revision
Revision total knee arthroplasty
title Retaining a Well-fixed Cone During Revision Total Knee Arthroplasty: Surgical Technique and Outcomes
title_full Retaining a Well-fixed Cone During Revision Total Knee Arthroplasty: Surgical Technique and Outcomes
title_fullStr Retaining a Well-fixed Cone During Revision Total Knee Arthroplasty: Surgical Technique and Outcomes
title_full_unstemmed Retaining a Well-fixed Cone During Revision Total Knee Arthroplasty: Surgical Technique and Outcomes
title_short Retaining a Well-fixed Cone During Revision Total Knee Arthroplasty: Surgical Technique and Outcomes
title_sort retaining a well fixed cone during revision total knee arthroplasty surgical technique and outcomes
topic Metaphyseal cones
Aseptic revision
Revision total knee arthroplasty
url http://www.sciencedirect.com/science/article/pii/S2352344124001626
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