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The Bone & Joint Journal
Vol. 103-B, Issue 6 | Pages 1103 - 1110
1 Jun 2021
Tetreault MW Hines JT Berry DJ Pagnano MW Trousdale RT Abdel MP

Aims

This study aimed to determine outcomes of isolated tibial insert exchange (ITIE) during revision total knee arthroplasty (TKA).

Methods

From 1985 to 2016, 270 ITIEs were performed at one institution for instability (55%, n = 148), polyethylene wear (39%, n = 105), insert fracture/dissociation (5%, n = 14), or stiffness (1%, n = 3). Patients with component loosening, implant malposition, infection, and extensor mechanism problems were excluded.


The Bone & Joint Journal
Vol. 102-B, Issue 6 Supple A | Pages 107 - 115
1 Jun 2020
Tetreault MW Perry KI Pagnano MW Hanssen AD Abdel MP

Aims

Metaphyseal fixation during revision total knee arthroplasty (TKA) is important, but potentially difficult when using historical designs of cone. Material and manufacturing innovations have improved the size and shape of the cones which are available, and simplified the required bone preparation. In a large series, we assessed the implant survivorship, radiological results, and clinical outcomes of new porous 3D-printed titanium metaphyseal cones featuring a reamer-based system.

Methods

We reviewed 142 revision TKAs in 139 patients using 202 cones (134 tibial, 68 femoral) which were undertaken between 2015 and 2016. A total of 60 involved tibial and femoral cones. Most cones (149 of 202; 74%) were used for Type 2B or 3 bone loss. The mean age of the patients was 66 years (44 to 88), and 76 (55 %) were female. The mean body mass index (BMI) was 34 kg/m2 (18 to 60). The patients had a mean of 2.4 (1 to 8) previous operations on the knee, and 68 (48%) had a history of prosthetic infection. The mean follow-up was 2.4 years (2 to 3.6).


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_11 | Pages 29 - 29
1 Oct 2019
Tetreault MW Perry KI Pagnano MW Hanssen AD Abdel MP
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Introduction

Metaphyseal fixation during revision total knee arthroplasties (TKAs) is important, but potentially challenging with historical cone designs. Material and manufacturing innovations have improved the size and shape of cones available, and simplified requisite bone preparation. In a very large series, we assessed implant survivorship, radiographic results, and clinical outcomes of new porous 3-D printed titanium metaphyseal cones featuring a reamer-based system.

Methods

We reviewed 142 revision TKAs using 202 cones (134 tibial and 68 femoral) from 2015 to 2016. Sixty cases involved tibial and femoral cones. Most cones (149 of 202; 74%) were used for Type 2B or 3 bone loss. Mean age was 66 years, with 54 % females. Mean BMI was 34 kg/m2. Patients had a mean of 2.4 prior surgeries and 48% had a history of periprosthetic infection. Mean follow-up was 2 years.