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Short- and Mid-term Radiographic Outcomes of Ream-then-broaching Metaphyseal Cones During Revision Total Knee
Aria Darbandi1, Andrew Schaver1, Micah MacAskill1
1Department of Orthopaedic Surgery, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA.
Background:
The purpose of this study is to assess the short- and mid-term radiographic outcomes of a ream-then-broach metaphyseal cone design for revision total knee arthroplasty (rTKA).
Methods:
A retrospective, multicenter analysis of rTKA patients utilizing femoral and/or tibial metaphyseal cone placement from January 2017 to July 2022 was performed. Assessment of radiolucency was performed utilizing a novel "cones score" for radiolucency for tibial and femoral cones.
Results:
Sixty-four rTKAs (23 femoral and 59 tibial cones) with short-term follow-up (12-24 months) and 80 rTKA (24 femoral and 76 tibial cones) with mid-term follow-up (>24 months) were assessed. No intraoperative complications were reported. No cases of cone or stem aseptic loosening were observed. The cones scoring system had a significantly strong intraclass correlation between the 3 reviewers (P < .001). Of tibial cones, 96.6% and 96.1% had no change in cones scoring at short- and mid-term follow-ups, respectively. Of femoral cones, 87.0% and 100% had no change in cones scoring at short- and mid-term follow-ups, respectively. All tibial and femoral implants were deemed radiographically stable at last radiographic follow-up.
Conclusions:
The utilization of a ream-then-broach metaphyseal cones demonstrated excellent radiographic stability at short- and mid-term follow-ups. The use of this method has minimal risk of intraoperative or short-term failures. Surgeons should be familiar with this type of cone implantation system.
