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The Multiply Revised Knee: Techniques for What to Do Next
Joshua C Rozell1, Nicholas A Bedard2, Jesse I Wolfstadt3
1Department of Orthopaedic Surgery, NYU Langone Health, New York, New York.
The Journal of Arthroplasty
|April 9, 2026
Summary
This symposium offers guidance for complex revision total knee arthroplasty (TKA) surgeries. It focuses on safe surgical exposures, bone grafting, porous metal augmentation, and patellar management for better patient outcomes.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Multiply revised total knee arthroplasty (TKA) presents significant surgical challenges.
- Bone loss and extensor mechanism issues complicate TKA reconstruction.
- Patients expect durable fixation and improved function after revision TKA.
Purpose of the Study:
- Provide updated guidance for re-revision TKA.
- Focus on safe exposure, impaction grafting, porous metal augmentation, and patellar management.
- Equip readers with techniques for complex knee revision.
Main Methods:
- Review of standard and extensile surgical exposures for revision TKA.
- Discussion of impaction bone grafting techniques and outcomes.
- Evaluation of porous metal structural augmentation for fixation.
- Development of algorithms for patellofemoral management.
Main Results:
- Enhanced understanding of safe surgical approaches for revision TKA.
- Knowledge of impaction bone grafting and porous metal augmentation for improved fixation.
- Strategies for optimizing patellofemoral kinematics in revision cases.
Conclusions:
- The symposium provides comprehensive strategies for managing complex re-revision TKA.
- Readers will gain confidence in surgical exposures and fixation techniques.
- Algorithms for patellar management will improve functional outcomes in revision TKA.
