Mid-Term Results Following Tantalum Cones in One-Stage Knee Exchange for Periprosthetic Joint Infection: A Single Center Study

Abstract Background The use of tantalum cone to reconstruct extensive bone defects revision total knee arthroplasty (TKA) has been established. We aimed to evaluate the mid-term results following one-stage knee exchange for PJI utilizing tantalum cones. Methods Seventy-two patients (mean age 70 ±- 8.2 years) treated with a one-stage exchange for infected TKA utilizing porous tantalum cones, between 2011 and 2016, were retrospectively included. Either rotating or pure hinge system in combination with femoral and/or tibial cones was used. Survivorship analysis (septic and aseptic) was performed. Prospectively, functional outcome was assessed at a mean follow-up of 49.9 ± 18.8 months (range 24 to 88). Results A total of 15 patients (21%) were re-revised, eight (11.1%) for infection and seven (10%) for aseptic loosening, requiring cone exchange in 12 patients (17%). Cone-related survival free from any revision was 83% ± 3.8 SD (95%-confidence interval [CI] 74%-90%), and infection-free survival was 89% ± 4.2 SD (95%-CI 76%–93%). No significant correlation between the types of prosthesis used (p = 0.8) or implanted cones and failure (p = 0.6). History of a previous septic revision increased the risk of cone revision following the index surgery (p Conclusion First study that reports on outcomes of the one-stage exchange utilizing tantalum cones for knee PJI with additional severe bone loss. Mid-term cone-related and infection-free survival offered good results and provided reasonable functional outcomes.