Part II: Revision Total Knee Arthroplasty   |    
Implant Selection in Revision Total Knee Arthroplasty
Charles L. Nelson, MD; Terrence J. Gioe, MD; Edward Y. Cheng, MD; Roby C. ThompsonJr., MD
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Corresponding author: Charles L. Nelson, MD
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 2 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2003 Jan 01;85(suppl 1):S43-S51
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Revision total knee arthroplasty implants have evolved from fully constrained (fixed-hinge) to semiconstrained to contemporary constrained designs. The latter category includes nonlinked constrained (total condylar-III) designs ( Fig. 1) and rotating-hinge designs ( Figs. 2-A and 2-B).Additionally, the advent of limb-salvage procedures following tumor resection and other instances in which there is massive segmental bone loss, such as that seen after multiple failed arthroplasties (particularly following failed reimplantation for infection), has stimulated the development of modular or custom segmental replacement "megaprostheses" and the use of allograft-prosthesis composites. Segmental modular megaprostheses are rotating-hinge components with modular stems of varying lengths that are used to replace segmental femoral or tibial diaphyseal bone loss ( Fig. 3).
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