Distal Femoral Replacement in Complex Total Knee Arthroplasty Revisions

Revision knee arthroplasty can be challenging in the face of bone loss and joint instability. Modular endoprostheses are a limb salvage option in these situations. Design changes have led to second and third generation prostheses that are significantly improved. This has resulted in part from increased freedom of rotation that decreases stresses at the cement interface. These implants serve a different clinical niche than traditional condylar components. The modular rotating hinge knee prosthesis is a useful adjunct for knee arthroplasty revision for patients with inadequate bone stock, ligamentous instability, or difficult supracondylar femur nonunions, especially in low-demand elderly patients.