The role of stems and augments for bone loss in revision knee arthroplasty.

The treatment of bone deficiencies during revision knee arthroplasty remains a challenging problem. The primary treatment options for these bone deficiencies include the use of structural allografts, impaction bone grafting, and the use of prosthetic augments. There have been no comparative series demonstrating the superiority of any of these techniques. Supplemental stem fixation should be used when using one of these treatment approaches. Although the use of cementless stems is currently more popular, the available literature suggests that cemented stem fixation provides a more reliable and durable construct for revision knee arthroplasty associated with severe bone deficiency.