{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:04:15Z","timestamp":1767830655014,"version":"3.49.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee Surg &amp; Relat Res"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Revision knee arthroplasty presents a number of challenges, including management of bone loss. The goal in managing moderate to large bone defects is fixation that is sufficient enough to allow early weight-bearing. The purpose of this study was to describe the surgical technique and clinical and radiographic outcomes of patients treated with porous tantalum metaphyseal cones in combination with long uncemented diaphyseal-engaging stems to manage tibial bone loss in revision total knee arthroplasty (TKA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>Thirty-six aseptic revision TKAs were performed at our institution between 2016 and 2019 by two senior authors. A single trabecular metal tantalum cone combined with a long (100 or 155\u00a0mm) press fit, diaphyseal-engaging stem was used in all cases to reconstruct metaphyseal bone defects and to augment tibial fixation. Cemented stems were excluded. The tibiofemoral angle was measured along the tibial and femoral shaft axes on the weight-bearing anteroposterior radiograph at final follow-up (range 15\u201356\u00a0months). All clinical and surgical complications, reoperations, and revisions of any component were recorded. Survivorship free of revision was evaluated at the time of the latest follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The mean Knee Society Score (KSS) and Knee Society Function Score (KSS-F) improved significantly from 29.7 points preoperatively (range 11\u201354 points) to 86 points (range 43\u201399 points) and from 20.4 points preoperatively (range 0\u201355 points) to 72.3 points (range 30\u201390 points) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), respectively. Eleven tibial constructs (30.5%) had incomplete, nonprogressive radiolucent lines (\u2264\u00a02\u00a0mm). All tibial cones demonstrated osteointegration. One patient underwent a full revision for periprosthetic joint infection, and survivorship free of any component revision was 91.7% at final follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Hybrid fixation with uncemented diaphyseal-engaging stems and porous tantalum metaphyseal cones resulted in radiographic lack of osteolysis, good clinical outcomes, and survivorship of 91.7% at a median follow-up of 33\u00a0months when considering all-cause revision as the endpoint.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s43019-022-00141-7","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T12:03:05Z","timestamp":1646913785000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The use of tantalum cones and diaphyseal-engaging stems in tibial component revision: a consecutive series"],"prefix":"10.1186","volume":"34","author":[{"given":"P.","family":"Spinello","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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