{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:44:14Z","timestamp":1790858654372,"version":"4.1.0"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>As the volume of primary total knee arthroplasties continues to rise, so will the volume of revision arthroplasties. Bone loss is commonly encountered in revision surgery and must be managed appropriately to optimize outcomes. The concept of zonal fixation highlights the importance of attaining secure fixation within each of the three major osseous zones: the epiphysis, the metaphysis, and the diaphysis. While each zone is important, the metaphysis carries particular significance. The development of new implants such as metaphyseal cones and sleeves has greatly expanded the orthopedic surgeon's armamentarium to allow for solid metaphyseal fixation in virtually every case.<\/jats:p>","DOI":"10.1055\/s-0041-1735281","type":"journal-article","created":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T23:06:33Z","timestamp":1631315193000},"page":"1402-1407","source":"Crossref","is-referenced-by-count":29,"title":["Zonal Fixation in Revision TKA: The Key Is Metaphyseal Fixation"],"prefix":"10.1055","volume":"34","author":[{"given":"Jason H.","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Orthopaedic Institute, Zucker School of Medicine at Hofstra\/Northwell, Lenox Hill Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles R.","family":"Scuderi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Orthopaedic Service Line at Northwell Health, Zucker School of Medicine at Hofstra\/Northwell, NYIT College of Osteopathic Medicine, Lenox Hill Hospital and Long Island Jewish Valley Stream Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,9,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1016\/j.arth.2020.02.030","article-title":"Projections and epidemiology of revision hip and knee arthroplasty in the United States to 2030","volume":"35","author":"A M Schwartz","year":"2020","journal-title":"J Arthroplasty"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/S0030-5898(05)70319-9","article-title":"Classification and preoperative radiographic evaluation: knee","volume":"29","author":"G A Engh","year":"1998","journal-title":"Orthop Clin North Am"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.3928\/0147-7447-20001001-14","article-title":"A practical approach to dealing with bone loss in revision total knee arthroplasty","volume":"23","author":"S D Lucey","year":"2000","journal-title":"Orthopedics"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1302\/0301-620X.97B2.34144","article-title":"Zonal fixation in revision total knee arthroplasty","volume":"97-B","author":"R Morgan-Jones","year":"2015","journal-title":"Bone Joint J"},{"issue":"446","key":"ref5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/01.blo.0000214414.06464.00","article-title":"Impaction grafting for bone defects in revision total knee arthroplasty","volume":"446","author":"P A Lotke","year":"2006","journal-title":"Clin Orthop Relat Res"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"3164","DOI":"10.1007\/s11999-011-1938-3","article-title":"Cementless revision TKA with bone grafting of osseous defects restores bone stock with a low revision rate at 4 to 10 years","volume":"469","author":"S A Hanna","year":"2011","journal-title":"Clin Orthop Relat Res"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1302\/0301-620X.91B2.21415","article-title":"Repair of defects and containment in revision total knee replacement: a comparative biomechanical analysis","volume":"91","author":"A D Toms","year":"2009","journal-title":"J Bone Joint Surg Br"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0883-5403(06)80109-9","article-title":"Screw and cement fixation of large defects in total knee arthroplasty. 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