Exposure in revision knee arthroplasty

Achieving adequate surgical exposure is a key to successful implant removal and re-implantation during revision knee arthroplasty. This, however, has to be done with careful attention to the vital bony and soft tissue structures about the knee so that risks are minimized and long-term function is optimized. An in-depth understanding of the normal anatomy of the knee as well as the patho-anatomy in the revision setting will facilitate pre-operative planning, preservation of vital structures intra-operatively and anticipation of problems intra- and post-operatively so measures can be taken to forestall these. Standard approaches to the knee often fail to provide the access required for revision surgery, and extensile approaches may need to be deployed. A variety of extensile approaches are available to the surgeon, each with its merits and drawbacks. We present a concise review of the standard and extensile approaches deployed in revision knee surgery, with an overview of the relevant anatomy and an evidence base for the different extensile approaches.