Useof TM cones in Revision TKA

Thorsten Gehrke, MD
Bone loss in revision total kneearthroplasty (TKA)is challenging for every orthopedic surgeon. Related osseous defects of femur and tibia might occur by stress shielding, particulate wear debris, chronic infection or even intraoperative at time of extraction and adherence of the previous implant.Several surgical techniques have been described to address bone loss in revision TKA. However, traditional methods have not always been sufficient to cover adequately bone defects that extend into the metaphysis or even the diaphysis. Smaller contained defects might be filled with cement or bone local bone grafting. Larger defects traditionally have been treated for with modular augments or bulk structural allograft, alternatively impaction bone-grafting with or without mesh augmentation has been established.

The general use of porous tantalum cones (TM cones) in the area of TKA revision has gained popularity within the last few years. Porous metal tantalum provides a new tool for modular reconstruction in these cases. Important characteristics of tantalum include its negative charge and interconnective pores, which form a scaffolding and surface for osteoblast-mediated bone ingrowth. We here present the surgical technique and clinical results of TM cones in the management of femoral and tibial bone defects in revision TKA.