ArticleBone & joint research2020
Metaphyseal cones in revision total knee arthroplasty: The role of stems.
Article in Bone & joint research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- No difference in long-term micromotion between fully cemented and hybrid fixation in revision total knee arthroplasty: a randomized controlled trial.The bone & joint journal · 2022Trial
- Revision Total Knee Arthroplasty in a Case of Operated Right Total Knee Arthroplasty with Implant Loosening and Pigmented Villonodular Synovitis.Journal of orthopaedic case reports · 2026Article
- The Effect of the Coronal Alignment of Extension Stem on Component Displacement and Stress During Total Knee Arthroplasty: A Finite Element Study.Orthopaedic surgery · 2026Article
- Early migration following revision total knee arthroplasty with tibial metaphyseal cones: a 2-year prospective RSA cohort study of 25 patients.Acta orthopaedica · 2026Article
- Managing large type 2a bone defects from osteoporotic tibial plateau fractures : a finite element analysis.Bone & joint research · 2026Article
- Biomechanical study on the treatment of tibial defects in total knee arthroplasty using the cement-screw and metal block with extension stem techniques: a finite element analysis.Frontiers in bioengineering and biotechnology · 2026Article
- Short-term results of metaphyseal sleeves in total knee arthroplasty for severe bone defects of the tibia.Journal of orthopaedics · 2025Article
- Biomechanical evaluation of asymmetric metaphyseal cone applications for lateral tibial plateau fractures : a finite element study.Bone & joint research · 2025Article
- Finite element analysis of three reconstruction strategies for AORI IIA tibial bone defects in TKA.Journal of orthopaedics · 2025Article
- Coronal Alignment in Revision Total Knee Arthroplasty: A Comparison of Cemented Vs Press-Fit Stems for Restoring Mechanical Axis.Arthroplasty today · 2025Article
- Rise of Revision Arthroplasties in Indian Subcontinent: An Inadvertent Future.Journal of orthopaedic case reports · 2025Article
- Robotic assisted TKA may allow for smaller polyethylene liner sizes compared to manual TKA with simultaneous removal of Hardware.Scientific reports · 2025Article
- Management of Bone Loss in Revision Total Knee Arthroplasty: An International Consensus Symposium.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2024Review
- A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties.Arthroplasty today · 2024Article
- Stability of Three-Dimensional Printed Custom-Made Metaphyseal Cone for Tibial Bone Defects Reconstruction: A Finite Element Analysis and Biomechanical Study.Orthopaedic surgery · 2023Article
- Acute Total Knee Arthroplasty for Unicondylar Tibial Plateau Fracture Using Metaphyseal Cones.Arthroplasty today · 2023Article
- Revision Total Knee Arthroplasty Utilizing Threaded Pins in Cement for Tibial Bone Loss.Medicina (Kaunas, Lithuania) · 2023Article
- Mechanisms of bone loss in revision total knee arthroplasty and current treatment options.Orthopedic reviews · 2023Article
- Tibial metaphyseal cones combined with short stems perform as well as long stems in revision total knee arthroplasty.ANZ journal of surgery · 2022Article
- Tibial Stem Extension versus Standard Configuration in Total Knee Arthroplasty: A Biomechanical Assessment According to Bone Properties.Medicina (Kaunas, Lithuania) · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsMetaphyseal tritanium cones can be used to manage the tibial bone loss commonly encountered at revision total knee arthroplasty (rTKA). Tibial stems provide additional fixation and are generally used in combination with cones. The aim of this study was to examine the role of the stems in the overall stability of tibial implants when metaphyseal cones are used for rTKA.
methodsThis computational study investigates whether stems are required to augment metaphyseal cones at rTKA. Three cemented stem scenarios (no stem, 50 mm stem, and 100 mm stem) were investigated with 10 mm-deep uncontained posterior and medial tibial defects using four loading scenarios designed to mimic activities of daily living.
resultsSmall micromotions (mean < 12 µm) were found to occur at the bone-implant interface for all loading cases with or without a stem. Stem inclusion was associated with lower micromotion, however these reductions were too small to have any clinical significance. Peak interface micromotion, even when the cone is used without a stem, was too small to effect osseointegration. The maximum difference occurred with stair descent loading. Stress concentrations in the bone occurred around the inferior aspect of each implant, with the largest occurring at the end of the long stem; these may lead to end-of-stem pain. Stem use is also found to result in stress shielding in the bone along the stem.
conclusionWhen a metaphyseal cone is used at rTKA to manage uncontained posterior or medial defects of up to 10 mm depth, stem use may not be necessary.
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