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Porous metal cones: gold standard for massive bone loss in complex revision knee arthroplasty? A systematic review of current literature

  • Knee Revision Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Revision knee arthroplasty is increasing, and in that case, bone loss management is still a challenging problem. In the last years, the body of literature and interest surrounding porous metal cones has grown, but few systematic evaluations of the existing evidence have been performed. The aim of our systematic review is to collect and critically analyze the available evidence about metal cones in revision knee arthroplasty especially focusing our attention on indications, results, complications, and infection rate of these promising orthopaedic devices.

Materials and methods

We performed a systematic review of the available English literature, considering the outcomes and the complications of tantalum cones. The combinations of keyword were “porous metal cones”, “knee revision”, “bone loss”, “knee arthroplasty”, “periprosthetic joint infection”, and “outcome”.

Results

From the starting 312 papers available, 20 manuscripts were finally included. Only one included study has a control group. The main indication for metal cones is type IIb and III defects according AORI classification. Most of the papers show good clinical and radiological outcomes with low rate of complications.

Conclusion

The examined studies provide encouraging clinical and radiological short-to-mid-term outcomes. Clinical studies have shown a low rate of aseptic loosening, intraoperative fractures, infection rate and a lower failure rate than the previous treatment methods. Higher quality papers are needed to draw definitive conclusions about porous metal cones.

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Authors and Affiliations

  1. U.O. Clinica Ortopedica e Traumatologica, Ospedale Policlinico San Martino IST, largo R. Benzi 10, 16132, Genoa, GE, Italy

    Stefano Divano, Luca Cavagnaro, Andrea Zanirato, Marco Basso, Lamberto Felli & Matteo Formica

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  1. Stefano Divano
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  2. Luca Cavagnaro
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Correspondence to Stefano Divano.

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Divano, S., Cavagnaro, L., Zanirato, A. et al. Porous metal cones: gold standard for massive bone loss in complex revision knee arthroplasty? A systematic review of current literature. Arch Orthop Trauma Surg 138, 851–863 (2018). https://doi.org/10.1007/s00402-018-2936-7

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