Salvage Options for the Failed Total Knee 
Arthroplasty

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Total knee arthroplasty (TKA) is a highly successful procedure, but increasing numbers lead to more revision surgeries.
• Multiple failed revision TKAs present challenges, potentially limiting further arthroplasty options.
• Significant bone loss or chronic infection after revision TKA necessitates evaluating advanced limb salvage or amputation techniques.

Purpose of the Study:

• To review modern techniques for managing patients with multiple failed revision TKAs.
• To discuss limb salvage versus transfemoral amputation as final treatment options.
• To address challenges of bone loss and chronic infection in complex revision knee arthroplasty.

Main Methods:

• Literature review of modern techniques for complex revision TKA.
• Analysis of limb salvage options including distal femur replacement, total femur arthroplasty, and knee arthrodesis.
• Evaluation of transfemoral amputation as a final reconstructive option.

Main Results:

• Advanced reconstructive techniques exist for complex revision TKA cases.
• Distal femur replacement, total femur arthroplasty, and knee arthrodesis offer limb salvage possibilities.
• Transfemoral amputation remains a viable option when limb salvage is not feasible.

Conclusions:

• Patients with multiple failed revision TKAs and significant bone loss or infection require careful consideration of treatment options.
• Modern techniques provide alternatives to amputation, but amputation remains crucial in select cases.
• Effective management strategies are vital for optimizing outcomes in complex revision knee arthroplasty.