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Are Proud Tibial Cone Constructs an Effective Alternative to Those That are Fully Seated in Revision Total Knee Arthroplasty?

Authors
  • Hollenberg, Alex M1
  • Szczecinski, Eric J1
  • Van Roekel, Nickolas L1
  • Pavlesen, Sonja1
  • Deliberato, David G1
  • Rachala, Sridhar R1
  • 1 Department of Orthopaedics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.
Type
Published Article
Journal
The Journal of arthroplasty
Publication Date
Feb 01, 2024
Volume
39
Issue
2
Pages
466–471
Identifiers
DOI: 10.1016/j.arth.2023.08.048
PMID: 37598782
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This study compared the clinical, radiographic, and patient-reported outcomes between patients treated with the traditional fully seated tibial cone construct and those with the novel proud tibial cone construct in revision total knee arthroplasty (rTKA). This was a retrospective study of 56 adult patients who had a minimum 2-year follow-up and underwent rTKA with either the fully seated (n = 18 knees) or proud (n = 42 knees) tibial cone construct between 2010 and 2020. The electronic medical record was reviewed for demographic, clinical, and radiographic data. Knee Injury and Osteoarthritis Outcome Scores (KOOS) were collected. All patients had improved mechanical alignment postoperatively regardless of surgical technique. All patients showed good evidence of osseointegration without loss of fixation at the latest follow-up. There were no significant differences in the complication rate or re-revision rate between the groups. KOOS Function in Sport and Recreation (Sport/Rec) scores were significantly higher for patients treated with the fully seated construct (mean 57 [range, 20 to 95] versus 38 [range, 0 to 75], P = .04); however, no significant differences were present for the other KOOS subscales or KOOS Jr. The proud tibial cone construct may be an effective alternative to the fully seated construct in the setting of severe bone loss in rTKA. The proud construct avoids a proximal tibial cut, and thus is a bone-preserving technique that provides good fixation, reduces operative time, prevents potential iatrogenic injuries, decreases the need for tibial augments, saves costs, and improves the ease of restoring joint height. Copyright © 2023 Elsevier Inc. All rights reserved.

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