IV-Soft tissue reconstruction:

Symmetric media! and lateral collateral ligament tension in both flexion and extension as well as equal sizes of the flexion and extension gaps should be achieved prior to implantation of the final components (94).

Medial-lateral soft tissue balancing, requires release of contracted medial or lateral ligaments and tendons or, alternatively, advancement and reconstruction of lax ligaments (94).

Flexion-extension balancing ma)' involve release of contracted posterior soft tissue Jb-ut also is affected by variation in the size and position of the implants (94).

If adequate medial-lateral and flexion-extension stability cannot be

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V-Bony deficits:

At the time of revision, the surgeon should make sure all the materials for reconstruction are available. These include wedges, blocks, allografts, and special components (93).

Assessment of bone loss must be a part of the preoperative planning process and must be repeated during the revision operation (87).

Intraoperative assessment is the most accurate method of determining the remaining bone stock, and developing an exact strategy for reconstruction (87).

The classification system of the Anderson Orthopaedic Research Institute (AORI) provides guidelines for bone defect management at the time of revision total knee arthroplasty (95).