Most problems encountered in complex revision total knee arthroplasty can be managed with the wide range of implant systems currently available. Modular metaphyseal sleeves, metallic augments and cones provide stability even with significant bone loss. Hinged designs substitute for significant ligamentous deficiencies. Catastrophic failure that precludes successful reconstruction can be encountered. The alternatives to arthroplasty in such drastic situations include knee arthrodesis, resection arthroplasty and amputation. The relative indications for the selection of these alternatives are recurrent deep infection, immunocompromised host, and extensive non-reconstructible bone or soft-tissue defects.


  • No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

    This paper is based on a study that was presented at the Winter 2011 Current Concepts in Joint Replacement meeting in Orlando, Florida, 7th – 10th December.

  • Received August 20, 2012.
  • Accepted August 20, 2012.
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