Bone loss in revision total knee arthroplasty: graft options and adjuncts

The treatment of small bone defects in revision total knee arthroplasty should make immediate full weight bearing and full therapy possible, provide long-term stability for the implants, and restore bone stock. These objectives are achieved with bone grafts if the defects are cavitary or small (involving less than one fourth of the cortical rim) segmental defects. These objectives are achieved with porous metal augments if the defects are segmental and involve more than one fourth of the cortical rim. The treatment of bone loss on the femur must allow the re-establishment of the distal and posterior joint lines as well as provide a firm fixation base for the implants.