ReviewCureus2025
Outcomes and Challenges of Optimal Fixation Selection for Metaphyseal Fixation Techniques in Revision Knee Arthroplasty According to Bone Defects: A Systematic Review.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Manual versus robotic-assisted revision total knee arthroplasty for instability : a one-year cohort analysis.Bone & joint open · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Revision total knee arthroplasty (rTKA) is often complicated by metaphyseal bone loss, requiring stable fixation techniques to restore function and alignment. Metaphyseal sleeves and cones have shown promising clinical outcomes, particularly in cases of severe bone defects. However, no gold standard therapy has been established. Therefore, this review aimed to evaluate and compare the clinical and radiological outcomes of metaphyseal sleeves and cones in rTKA, considering the severity of bone defects and related complications. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirteen studies published between 2004 and 2024 were included, evaluating clinical and radiological outcomes of metaphyseal sleeves and cones across varying Anderson Orthopaedic Research Institute (AORI) defect classifications. Metaphyseal sleeves demonstrated a 100% survival rate over five years across multiple studies, while metaphyseal cones showed a survivorship rate of 91 91%. Both techniques demonstrated satisfactory functional recovery, although outcome measurement tools varied across studies, such as the Knee Society Score (KSS), which showed progressive improvement in most patients in both groups. Sleeves were associated with a higher incidence of intraoperative fractures (3.7%), whereas cones required more re-revision surgeries (5.33%), often due to issues with cement fixation. Both metaphyseal sleeves and cones provided effective fixation in rTKA. Neither method proved universally superior; the choice should be tailored to the severity of the defect and individual patient factors to balance durability, risk, and clinical outcome.
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Registered trials
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