Bone loss in revision total knee arthroplasty

Bone loss management in revision total knee arthroplasty (TKA) is a challenge for the surgeon. The correct assessment of bone losses is mandatory to achieve good stability of the implant. Bone losses can be divided into contained or not contained. Furthermore, different classification systems have been proposed considering the size and the location of the defect. Different techniques are available to treat bone loss, depending on their size and location. For smaller defects, cement, morcellized bone graft or metal augments can be used. In cases of moderate defect, if the depth is less than 5 mm, cement can still be used, and it can be reinforced with screws. If the defect is more than 5 mm and less than 10 mm a metal augment is generally indicated. For defect bigger than 10 mm structural allograft, tantalum cones or sleeves may be indicated. In bicondylar massive defects metal augments, tantalum cones, structural allograft or tumor prosthesis may be required, based on patient's age and level of activity. In this manuscript we describe different techniques to treat bone loss in revision TKA, in association to a brief literature analysis.