Novel Utilization of Revision Cones for Femoral Condyle Lysis in Revision Total Knee Arthroplasty.

Abstract

Significant bone loss is a major challenge in revision total knee arthroplasties (TKAs), especially with large femoral condylar defects. Restoring the metaphyseal-diaphyseal junction and central bone loss is critical for stability and reducing risk of component loosening. We describe a novel technique that uses a helical burr to modify porous metal cones intraoperatively, creating a custom fit without impinging on the femoral component. This approach promoted reliable osseointegration and stability in two patients with femoral condyle osteolysis. Additionally, we present a review of data demonstrating the success of metal cones in achieving osseointegration and decreased instability. Early findings suggest that intraoperative cone sizing and custom modification is a reliable technique for optimizing outcomes in the setting of femoral bone loss in revision TKA.