SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Metaphyseal cones and sleeves are similar in improving short- and mid-term outcomes in Total Knee Arthroplasty revisions.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Artificial intelligence in total and unicompartmental knee arthroplasty.BMC musculoskeletal disorders · 2024Pooled it
- Metaphyseal cones in septic revision total knee arthroplasty: A retrospective cohort study with minimum 2-year follow-up.Journal of experimental orthopaedics · 2026Article
- Additively Manufactured Partially Porous PAEK Topologies for Proximal Tibia Revision Cones and Sleeves.Annals of biomedical engineering · 2026Article
- Big data analysis reveals significant increases in complications, costs, and hospital stay in revision total knee arthroplasty compared to primary TKA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Stem fixation techniques in revision total knee arthroplasty: A systematic review and meta-analysis.Journal of experimental orthopaedics · 2025Review
- Excellent mid- to long-term survival of tantalum metal cones in a case series of revision knee arthroplasty with severe bony defects.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Metaphyseal Metal Sleeves for Reconstruction of Severe Knee Bone Defects: Excellent Survival Rate at a Mean Follow-Up of 6.4 Years.Orthopaedic surgery · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this systematic review and metanalysis was to assess clinical and radiological outcomes of metaphyseal sleeves and cones and to identify their possible advantages and disadvantages.
methodsA comprehensive search from the inception of the databases to March 2021 was performed on Medline, Scopus, CINAHL, Cochrane, Embase, Ovid, and Google scholar databases. Coleman Methodology Score was used for quality assessment. Author, year of publication, type of study, level of evidence, sample size, number of patients, number of knees treated, mean age, gender, mean follow-up, clinical outcomes, complications, the reason for revision and, type of prosthesis were extracted for analysis. Clinical studies providing data about patient's outcomes after the primary and Total Knee Arthroplasty revision with the usage of sleeves or cones and a minimum of 2 years of follow-up were included.
resultsThe literature search and cross-referencing resulted in a total of 93 articles, but only 30 articles were appropriate for the systematic review. Comparable clinical results were reported between cones and sleeves. The meta-analysis showed a greater incidence of intraoperative fractures in patients treated with sleeves (1.6%, [95% CI 0.7; 3.4] in cones and 4.6%, [95% CI 3.3; 6.4] in sleeves, p = 0.01), while the risk of postoperative fractures (4.3%, [95% CI 2.7; 7] in cones and 2.1%, [95% CI 1.2; 3.5] in sleeves, p = 0.04) and infections (8.5%, [95% CI 6; 12] in cones and 3.7%, [95% CI 2.1; 7.3] in sleeves, p = 0.03) was higher with cones.
conclusionA higher incidence of intraoperative fracture was reported in patients treated with sleeves, while a higher rate of postoperative fractures and infections was described in patients treated with cones. Nonetheless, complications were reported in both groups. LEVEL OF EVIDENCE: III.
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Registered trials
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