Minimum One-Year Outcomes of a Newly Designed Metaphyseal Tibial and Femoral Cone in Revision Knee Arthroplasty

Objectives: Revision total knee arthroplasty (rTKA) is inherently challenging but further complicated in instances of excessive bone loss. Revision cones, particularly newly designed 3-dimensional (3D) titanium constructs, are one of the options currently available to address bony defects. This study aimed to report on the minimum one- year survivorship of a newly released rTKA cone, hypothesizing that the survivorship of the construct would be favorable. Material and Methods: A previously described cohort of 24 patients having received either femoral or tibial cones with a matching knee arthroplasty system was assessed at a minimum one-year follow-up. Data collected included the cone location (femoral or tibial), demographics including age, sex, and body mass index (BMI), reoperations, cone survivorship, and patient-reported outcomes (PROs), including the Knee Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) and visual analog scale (VAS). Data was assessed using student’s t-tests, with p < 0.05 indicating statistical significance. Results: The cohort of 24 patients was 16 (66.7%) females, with a mean age of 68.4 ± 7.7 years old and a BMI of 32.1 ± 4.7. The mean follow-up was 17.5 ± 5 months (range: 12, 26). At the time of follow-up, no patients had experienced any reoperations or revisions, demonstrating 100% survivorship of the cone construct. Regarding PROs, statistically significant improvements were noted in both the KOOS JR (mean change, +12.4 points; 95% CI, 4.6–20.1; p =0.0041) and VAS (mean change, −20.6 points; 95% CI, −36.8 to −4.4; p =0.0164) at one year compared to preoperative scores. Conclusion: This study reports on the durability and feasibility of a newly designed rTKA cone, which is, to our knowledge, the longest timepoint of reporting for this particular device. Additionally, this study supports the existing body of literature on other similarly designed (3D printed titanium) constructs.