ArticleJournal of experimental orthopaedics2026
Anatomical 3D-printed metaphyseal cone in revision total knee arthroplasty: A short-term clinical and radiological follow-up evaluation.
Article in Journal of experimental orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Bone loss is commonly encountered during revision total knee arthroplasty (R-TKA), and metaphyseal cones are often used to address these defects. In addition, they can enhance Zone 2 fixation in R-TKA in the presence of poor bone quality. The aim of this study was to evaluate the short-term clinical and radiological outcomes of a novel three-dimensional (3D)-printed metaphyseal cone in R-TKA. Methods: This single-centre, single-surgeon prospective study included all patients who underwent R-TKA using a novel 3D-printed anatomical metaphyseal cone (AMF, ENOVIS®) with a minimum follow-up of 24 months. Patient demographics and operative details were recorded. Postoperative assessments included the Knee Society Score (KSS), Oxford Knee Score (OKS) and Short Form-12 (SF-12). Radiographic evaluation focused on radiolucent lines, implant or cone loosening and the cone's ability to replicate proximal tibial anatomy. Complications, reoperations and revisions for any reason were documented. Results: Thirty patients (31 knees) underwent R-TKA with a total of 48 cones (24 tibial and 24 femoral), with a mean follow-up of 37.3 months (standard deviation [SD] 8.8). In 48.4% of cases, cones were used on both the tibial and femoral sides. No intraoperative fractures occurred during cone preparation. All patients demonstrated significant improvement in clinical outcomes. Radiographic evaluation showed no evidence of cone loosening and accurate reproduction of proximal tibial anatomy. Survivorship free from cone revision, including for aseptic loosening, was 100%. Survivorship free from any revision or reoperation was also 100%. Conclusion: This novel 3D-printed anatomical metaphyseal cone demonstrated excellent short-term outcomes, with no early loosening and accurate replication of proximal tibial morphology. However, longer-term follow-up and a larger cohort are required to confirm these preliminary findings. Level of Evidence: Level IV.
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