Scientific Articles   |    
Early Results of the Use of Tantalum Femoral Cones for Revision Total Knee Arthroplasty
James L. Howard, MD, MSc, FRCSC1; Jeremy Kudera, MD2; David G. Lewallen, MD2; Arlen D. Hanssen, MD2
1 London Health Sciences Centre, 339 Windermere Road, London, ON, Canada N6K 4R1. E-mail address: james.howard@lhsc.on.ca
2 Mayo Clinic, 200 First Street, Rochester, MN 55905
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Zimmer).

Investigation performed at the Mayo Clinic, Rochester, Minnesota

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Mar 02;93(5):478-484. doi: 10.2106/JBJS.I.01322
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case



The optimum treatment method for large femoral bone defects during revision knee replacement has not been established. The purpose of the present study was to determine the initial results associated with the use of porous tantalum metaphyseal cones for the treatment of severe femoral bone loss at the time of revision total knee arthroplasty.


Porous tantalum metaphyseal cones were implanted during twenty-four revision total knee replacements. The study group included thirteen women and eleven men with a mean age of sixty-four years at the time of the procedure. The indications for the revision procedure included aseptic loosening of the femoral component (eleven patients), second-stage reimplantation for the treatment of deep infection (seven patients), severe osteolysis around a well-fixed femoral component (three patients), periprosthetic femoral fracture (two patients), and severe knee instability (one patient).


The patients were followed for an average of thirty-three months (range, twenty-four to fifty months). Overall, the average Knee Society clinical score improved from 55 points preoperatively to 81 points at the time of the latest follow-up. Radiographic evaluation was completed for twenty patients after a mean duration of follow-up of thirty-five months. All femoral cones appeared well fixed radiographically, with no evidence of complications related to the cone.


At the time of short-term follow-up, the porous tantalum metaphyseal femoral cones effectively provided structural support for the femoral implants of a revision total knee arthroplasty in this series. The potential for long-term biologic fixation may provide durability for reconstructions. Long-term follow-up and comparison with alternative reconstructive techniques will be required to evaluate the true effectiveness of this implant.

Level of Evidence: 

Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    Oregon - The Center - Orthopedic and Neurosurgical Care and Research