Evidence map›Paper›PMID 40686661›Full record

ArticleArthroplasty today2025

A Cone Stacked on a Cone Within a Cone: A Technique for Reconstructing Proximal Third Tibial Shaft Fractures During Revision Total Knee Arthroplasty.

Stefano Ghirardelli, Peter Sculco, Jeffrey O'Donnell, Daniel Buchalter, Elizabeth Gausden, Brian Chalmers, Thomas Sculco

Abstract readCase Reports
In one paragraph

Article in Arthroplasty today, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stefano GhirardelliDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Peter SculcoDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Jeffrey O'DonnellDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Daniel BuchalterDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Elizabeth GausdenDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Brian ChalmersDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Thomas SculcoDepartment of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Bone loss in revision total knee arthroplasty is an increasing challenge, especially as younger active patients undergo primary procedures. Treatment options for severe tibial bone loss include cement, allograft, metal augments, metaphyseal cones, sleeves, and megaprostheses. Novel combinations of these have enabled complex limb salvage without resorting to megaprostheses or amputation. This case report presents a technique utilizing three cones-configured in both cone-in-cone and cone-on-cone fashion-to bypass and stabilize a metadiaphyseal fracture during revision total knee arthroplasty. We outline the indications for selecting each construct and explain how to achieve axial and rotational stability in different bone zones using patient-specific cones. This approach provides an alternative to traditional reconstruction methods in complex cases with significant bone loss and periprosthetic fracture.

Indexed as

Arthroplasty complicationBone lossMetaphyseal coneRevision knee arthroplastyTrabecular metal cone

Identifiers

PMID40686661
PMCPMC12274728

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.