Uso de conos de metal trabecular para defectos óseos severos en cirugía de revisión de reemplazo total de rodilla

Introduction: Major bone defects represent a challenge during revision total knee arthroplasty (TKA) and there is still considerable debate about the best therapeutic option. The purpose of this study was to retrospectively assess the osseointegration rate of trabecular metal cones in revision TKA with severe bone defects. The secondary purpose was to evaluate the functional outcomes and complication and reoperation rates. Materials and Methods: A single-center, retrospective cohort including all consecutive cases of revision TKA using trabecular metal cones. All patients with a minimum 2-year follow-up were included in the study. Reasons for revision, number of previous surgeries, type of bone defect, and number and type of trabecular cones used were evaluated. Clinical and radiological outcomes were also analyzed as well as complications rates. Results: 35 patients (49 cones) were evaluated with a mean follow-up of 32.1 months (24-62). Most defects were localized in the tibia and were classified as AORI type 3. The rate of osseointegration of the cones was 94%; the complication rate, 20%; and the reoperation rate, 8.5%. The mean KSS increased from 39 preoperatively to 71 at the last follow-up, and the mean VAS from 8 to 2.5. Conclusion: The excellent osseointegration rate (94%), added to the good clinical outcomes, position the trabecular metal cones as an alternative to treat severe bone defects.