Finely engineered
for bone

CONCEPT


Femoral and tibial cavitary bone defects are challenging scenarios, particularly encountered during revision total knee arthroplasty.
A proper management of these defects is crucial for achieving a stable construct, since bone loss compromises the stability of the implanted components.[1,2]
Leveraging its extensive experience with 3D Metal, Medacta has designed 3D Metal Femoral and Tibial Cones.
The 3D porous structure has been finely engineered to maximize the implant’s primary stability and to promote a structural and functional connection with the bone.[3,4,5]
As a result, 3D Metal Cones can be used to fill and reconstruct areas of bone deficiencies for efficiently managing even the most complex situations.[6,7]

“I truly believe that Medacta's 3D Metal Cones are a valuable solution. In my experience, these cones are extremely versatile and very user-friendly when filling cavitary bone defects in the diaphysis of the femur and the metaphysis of the tibia. They assist in recreating a proximal, structural foundation for the revision implant by achieving reliable proximal fixation and force distribution throughout the remaining host bone. The addition of these cones to Medacta’s GMK Revision System allows me to efficiently and reliably tackle my most difficult revision cases.”
Dr. David Manning, MD

"It always makes me very happy to have 3D Metal Cones in challenging knee revision cases at hand. In such environment, they show their true nature of optimized design and versatile anatomic fit. The reduced wall thickness and the overall adaptability of cones are advantageously coupled with offset connectors and large diameter stems. The state-of-the-art manufacturing process, i.e. 3D printing, makes them extremely light and easy to use, but at the same time very robust and resistant. Absolutely my choice when metaphyseal tibia is in poor condition."
Dr. Dragan Jeremic

“I was pleased with the press-fit of these 3D Metal Tibial Cones, especially the immediate fixation provided by the highly porous 3D layer. The solid central layer of these cones is also very useful, as it prevents cement extravasation when cementing inside the eone. I was also pleased with the simple instrumentation, which was straightforward and complementary to my typical revision workflow."
Dr. Kevin D. Hardt, MD

KEY FEATURES

PATENTED TRIPLE-LAYER STRUCTURE

The unparalleled versatility of the 3D printing technology allows for selectively combining different patterns within the component.

  • The internal porous layer, closer to the tibial keel or to the femoral revision stem, promotes bone cement interlocking.
  • The solid layer in the middle keeps the cement in place, thereby preventing the filling of the pores of the outer layer.
  • The external porous layer promotes an efficient structural and functional connection with the bone, allowing for the cementless fixation of the cone to the bone.

ANATOMIC FIT AND INTRAOPERATIVE VERSATILITY

  • The thickness of the cones is optimized for the use of all the GMK Revision System options (e.g., offset connectors, augments, and stems with large diameters) for an efficient management of the most challenging scenarios.
  • The conical shape allows for better accommodation of the bone anatomy.
  • The openings incorporated in the design of the cones allow for a flexible positioning of the construct (i.e., rotational and translational freedom).

MINIMAL AND INTUITIVE SURGICAL TECHNIQUE

  • Dedicated instruments allow for efficiently guiding the surgeon in each step of the procedure.
  • Only a few additional steps are needed to prepare the bone and to implant the cone, allowing for maintaining the preferred knee revision surgical workflow.
PRODUCT RANGE

3D METAL FEMORAL CONES

  • 4 sizes 
  • Symmetric design
  • Material: Ti6Al4V (ASTM F2924)

3D METAL TIBIAL CONES

  • Centered (symmetric option): 4 sizes 
  • Eccentric (asymmetric option): 3 sizes
  • Material: Ti6Al4V (ASTM F2924)
REFERENCES

[1] D. D. Bohl et al., «Do Porous Tantalum Metaphyseal Cones Improve Outcomes in Revision Total Knee Arthroplasty?», The Journal of Arthroplasty, vol. 33, n. 1, pagg. 171–177, gen. 2018, doi: 10.1016/j.arth.2017.07.033.
[2] P. Derome, A. Sternheim, D. Backstein, e M. Malo, «Treatment of Large Bone Defects With Trabecular Metal Cones in Revision Total Knee Arthroplasty: Short Term Clinical and Radiographic Outcomes», The Journal of Arthroplasty, vol. 29, n. 1, pagg. 122–126, gen. 2014, doi: 10.1016/j.arth.2013.04.033.
[3] Medacta: data on file.
[4] L. Dall’Ava, H. Hothi, A. Di Laura, J. Henckel, A. Hart. 3D Printed Acetabular Cups for Total Hip Arthroplasty: A Review Article. Metals 2019, 9, 729.
[5] L. Dall’Ava, H. Hothi, J. Henckel, A. Di Laura, P. Shearing, A. Hart. Comparative analysis of current 3D printed acetabular titanium implants. 3D Printing in Medicine 2019; 5:15. 
[6] C. L. Jensen, M. M. Petersen, H. M. Schrøder, G. Flivik, e B. Lund, «Revision Total Knee Arthroplasty With the Use of Trabecular Metal Cones», The Journal of Arthroplasty, vol. 27, n. 10, pagg. 1820-1826.e2, dic. 2012, doi: 10.1016/j.arth.2012.04.036.
[7] T. Bonanzinga, T. Gehrke, A. Zahar, S. Zaffagnini, M. Marcacci, e C. Haasper, «Are Trabecular Metal Cones a Valid Option to Treat Metaphyseal Bone Defects in Complex Primary and Revision Knee Arthroplasty?», Joints, vol. 6, n. 1, pagg. 58–64, dic. 2017, doi: 10.1055/s-0037-1608950.

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