Utilization of an Anteromedial Cortical Window for Tibial Component Removal During Revision Total Knee Arthroplasty.

Overview

Revision total knee arthroplasty often entails removal of well-fixed components. Tibial component removal is particularly challenging due to (I) mechanical barriers that limit circumferential disruption when pegs, keels, or stems are present; (II) restricted access to implant-cement and cement-bone interfaces within the proximal canal; and (III) the proximity of critical structures, including the collateral ligaments, patellar tendon, popliteal artery, and distal femur. We present a novel anteromedial cortical window technique that facilitates removal of well-fixed tibial components by improving access to the implant-cement, burr-cement, and cement-bone interfaces within the proximal tibial metaphysis. This technique is suited for cases not requiring posterolateral exposure, offering a less morbid alternative to tibial tubercle osteotomy with the option for conversion if greater exposure is needed.