Results of revision total knee arthroplasty associated with significant bone loss

The results of 40 revision total knee arthroplasties (TKAs) in 38 patients performed for aseptic failure with significant bone loss were reviewed. All knees were evaluated for at least two years, with an average of 41 months (range, two to nine years.) Seventy-five percent of the knees were considered excellent or good. Ten percent were considered failures. There were no infections. Overall complication rate was 30%, of which wound complications were the most common. Revision TKA remains demanding, but results can be improved by (1) restoring the mechanical alignment of the knee with accurate component positioning; (2) filling all bone defects with bone, cement, or modular spacers; (3) using stems to assist in component support; and (4) adherence to soft-tissue balancing and care.