09:20 AM

Study: Biomechanical Advantage of Metaphyseal Cones and Stems in Addressing Bone Defects in Revision TKA

AAOS Now reports on HSS study results published in Clinical Orthopaedics and Related Research finding that using metallic metaphyseal cones with short cemented stems to address moderate metaphyseal bone defects in revision total knee arthroplasty (TKA) reduced the risk of debonding at the implant-cement interface during activity, compared with short cemented stems without cones.

The study was presented at the American Academy of Orthopaedic Surgeons (AAOS) 2021 annual meeting by authors Fernando Quevedo-González, PhD, assistant scientist, and Michael P. Ast, MD, hip and knee surgeon and chief medical innovation officer. The authors said the goal of the study was to evaluate the “biomechanical justification” of cones in revision TKA.

Dr. Quevedo-Gonzalez explained the impetus for the study, “Despite the widespread use of metaphyseal augments, like cones, to supplement fixation in revision TKA, few studies have explored their biomechanical behavior as a means of justifying their routine use or provided biomechanical principles that can guide their use, including the role of the use of stemmed tibial components in combination with metaphyseal cones.”

According to Dr. Quevedo-Gonzalez, on the clinical takeaway of this study, “Metaphyseal cones may help reduce the risk of implant debonding from the cement mantle compared to using cement alone to fill the defect, although both techniques can provide comparable results in contained, moderately sized metaphyseal defects. Moreover, metaphyseal cones can allow using shorter stems with comparable biomechanical behavior to longer stems.”

Read the full article at AAOS.org.