Management of Bone Defects in Revision Total Knee Arthroplasty with Use of a Stepped, Porous-Coated Metaphyseal Sleeve

Abstract

Structural allografts or metal augments remain a suitable option for uncontained metaphyseal defects. Metaphyseal structural allografts may undergo stress-shielding, resorption, and late fracture. Metaphyseal sleeves offer long-term biologic fixation to host bone while creating a stable platform to receive a cemented femoral and/or tibial component⁷. This hybrid combination may provide mechanically protective properties to decrease the loads at the cement-bone interfaces and enhance loads to metaphyseal bone to ensure long-term implant fixation in the setting of substantial bone deficiencies^18-20.