Dzidzishvili L, Sáez D, Calvo E. Metaphyseal cones combined with diaphyseal impaction grafting provide good outcomes and survival in a complex revision total knee arthroplasty: a matched comparative analysis.
Eur J Orthop Surg Traumatol 2024;
34:577-583. [PMID:
37656276 DOI:
10.1007/s00590-023-03659-y]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/25/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE
To compare clinical and radiological outcomes, implant survivorship at a minimum of 1-year follow-up using metaphyseal trabecular cones with or without impaction grafting in a complex revision TKA.
METHODS
A retrospective comparative matched analysis was performed and 15 patients who underwent revision surgery using the combination of porous trabecular metaphyseal cone and diaphyseal impaction grafting (MC-IBG) were matched with a group of 13 patients who also underwent revision surgery using metaphyseal cone (MC) without impaction grafting. All included patients presented severe bone defect (AORI 2,3) and a rotating-hinge prosthesis were implanted.
RESULTS
Both groups were comparable regarding the baseline demographic and clinical data. Patients had previously undergone a mean of 4 (range, 2-12) and 3 (range, 2-5) previous procedures in the MC-IBG and MC groups, respectively. The indications for revision were aseptic loosening in 11 (73.3%) and 11 (84.6%) patients; prosthetic joint infection in 4 (26.7%) and 2 (15.4%) in the MC-IBG and MC groups, respectively. There was no significant difference in the mean postoperative Knee Society Score between the study groups (p = 0.806). Overall, 4 patients had further revision. Two patients were revised in the MC-IBG group, one patient for aseptic loosening and the second one after 2 episodes of instability. Two patients in the MC group presented prosthetic joint infection and underwent a two-stage reimplantation. No significant difference was observed between the study groups at comparison (p = 0.92).
CONCLUSION
Trabecular metal cones with diaphyseal impaction grafting provide an alternative technique in a complex revision TKA surgery with early clinical and radiographic success.
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