Having (1) reestablished the tibial platform, (2) stabilized the knee in flexion, and (3) stabilized the knee in extension, the revision arthroplasty is effectively complete. The trial components can be removed and the bone prepared for implantation of the permanent components. The three steps lend themselves to whatever implant is planned for the revision. Although posterior-stabilized implants generally provide a higher degree of stability for the revision, these steps can lead to a sound reconstruction when cruciate-retaining implants are selected. As has been indicated by the "decision points," circumstances arise when the pathology of the deformity dictates the best choice of implant.
The three steps to revision knee arthroplasty presented here provide the surgeon with an orderly approach based on sound surgical principles. Meticulous preoperative planning and adherence to the steps should allow the knee surgeon to overcome the daunting challenge of the revision knee arthroplasty (Fig. 8.7).
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