Reconstruction of Complex Distal Femur and Proximal Tibia Defects Using Tantalum Cones

Abstract

As the number of primary total knee arthroplasties increase, revision procedures with massive bone defects will also increase. Although multiple reconstructive options have been recommended, porous tantalum metaphyseal cones have the advantage of improved biological fixation because of their high porosity, interconnected pore space, and a modulus of elasticity similar to that of cancellous bone. Such features allow tantalum cones to fill bone defects while tolerating physiological loads. Indications for porous tantalum metaphyseal cones include patients with large contained or uncontained osseous defects that are typically categorized as Anderson Orthopaedic Research Institute type 2B or greater. The surgical technique is simpler than structural allograft reconstructions with decreased preparation time, resulting in a possible decrease in infection rates. The modularity of porous tantalum metaphyseal cones allows the surgeon to choose a size and position that best fits the individual defect encountered. Moreover, tantalum cones can be used with any revision system. Short-term clinical follow-up indicates that porous tantalum metaphyseal cones effectively provide structural support with the potential for long-term biological fixation and durable reconstructions.