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November 04, 2023
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Porous tantalum metaphyseal cones may provide durable fixation for revision TKA

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Key takeaways:

  • Revision total knee arthroplasty with porous tantalum metaphyseal cones yielded a 5-year survivorship from infection of about 90%.
  • Patients also had an end point for revision for any reason of 84%.

GRAPEVINE, Texas — Results presented here showed porous tantalum metaphyseal cones may yield durable fixation among patients undergoing revision total knee arthroplasty for severe femoral or tibial bone defects.

Donald S. Garbuz, MD, and colleagues recorded component survivorship, clinical outcomes, radiographic outcomes and any complications among 152 patients undergoing revision TKA with porous tantalum metaphyseal cones for aseptic loosening, second-stage reimplantation for infection, osteolysis with a well-fixed component or periprosthetic fracture.

OT1123Garbuz_AAHKS_Graphic_01
Data were derived from Garbuz DS, et al. Paper 3. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 2-5, 2023; Grapevine, Texas.

Although no patients had an aseptic revision, Garbuz said patients had a 5-year survivorship from infection of about 90% and the end point for revision for any reason was about 84%.

Donald S. Garbuz
Donald S. Garbuz

“As you would expect in this cohort, [periprosthetic joint infection] PJI was the most common reason [for reoperation],” Garbuz said in his presentation at the American Association of Hip and Knee Surgeons Annual Meeting. “We have to keep that in mind as we move to more cemented stems because these certainly will not be easy to remove.”

All cones showed osseointegration on radiographs with no evidence of cone loosening or subsidence at follow-up, according to Garbuz. He said patients had an overall satisfaction of approximately 80%, but a Forgotten Joint Score of 62%.

“We still could do better in terms of patient functional outcomes, as well as the [University of California Los Angeles] UCLA and Oxford scores,” Garbuz said. “They’re OK, but they’re not amazing.”