• Small (less than 5mm) uneontaincd detects can also be repaired with cement alone or eement and screws.
  Intermediate (5 to ULinm) imcontnined detects can be managed with modular wedges.
  Large (greater than 10 mm) uneontained defects arc best managed with modular augments or structural allourafts (93V
  5-Prosthetic selection :
  Implant selection is based primarily on the severity of bone loss and the status of the ligamentous and soft-tissue stabilizing structures at the time of revision surgery (95).-"
  The goal is to provide a stable knee and a stable implant with an axis of _rotatign near the normal axis with the use of the least-constrained implant ^xpectecftcTachieveTfns
  In the setting of ligamentous loss or insufficiency, increasing constraint from a posterior stabilized prosthesis to a nonlinked constrained or rotating-hinge prosthesis may be necessary (95).
  In the setting of massive segmental bone loss, a modular segmental replacement prosthesis or an allografi-prosthesis composite may be required (95).
  The primary advantages of canal filling cementless stems are ease of removal and greater retention of bone stock should rerevision become necessary (97).
  The results associated with canal-filling cementless steins have been comparable with those associated with cemented stems. Nelson et al. recommend the use of cementless stems for patients undergoing revision total knee arthroplasty (97).