Metaphyseal Sleeves and Metaphyseal Cones in Revision Total Knee Arthroplasty

Abstract

Metaphyseal cones and sleeves represent a viable option in aseptic and septic revision total knee arthroplasty with type IIb and III AORI bone defects. Both methods allow proper bone defects management with comparable clinical and radiological results and survival rates. The main advantages for metaphyseal sleeves and cones are that they allow fixation closer to articulation, which facilitates restoration of the joint line and provides better control of rotation alignment of the components. Primary stability, either axial and or rotational, is achieved intraoperatively with press-fit technique and the bone ingrowth ensures the secondary stability. Drawbacks include the cost-benefits debate, the need to remove extra bone for shape adaptation and difficult removal in revesion surgery.