Revision TKA: Component removal

Abstract

Polyethylene wear and aseptic loosening are the most frequent indications for revision of a total knee arthroplasty (TKA) (1). Occasionally, but rarely, the components are so loose that they can be very easily removed without even having to debond the component from the cement. But in cases of infection, instability or mal-alignment, removal of well-fixed components can be challenging and can be fraught with complications including significant iatrogenic bone loss and periprosthetic fracture (2). This can potentially significantly increase the complexity of the revision, extend the length of the surgical procedure and subsequently increase the risk of infection and could further compromise the ultimate functional outcome of the patient. A meticulous and systematic approach to remove the components is therefore of critical importance (3).