A, Porous metal cones are placed into metaphyseal defects for enhanced fixation. B, Radiograph of bi-lobed tibial cone used to augment defect from tibial plateau fracture nonunion. C, Sleeves that are attached to implant stem construct can enhance metaphyseal-contained or uncontained defects as seen in this anteroposterior and lateral radiograph of revision TKA in rheumatoid patient with poor bone.