Ten steps to an easier revision total knee arthroplasty

Revision total knee arthroplasty can be facilitated by proper preoperative planning, using an extensile incision, lysing of adhesions on the lateral gutter, exposing the medial and lateral aspects of the proximal tibia, and stabilizing the patellar tendon. If the patella cannot be everted safely, the surgeon should be prepared to do a rectus snip or tibial tubercle osteotomy. The components should be extracted axially after separation of the interfaces with a small sagittal saw or small osteotomes. The intramedullary canals of the femur and tibia should be used as references for the cutting blocks.