Abstract
Removing well-fixed components can be difficult. It can be required in instances of infection, malalignment, instability and polyethylene wear. Success requires patience, skill and the use of correct instruments. Using too much force or haste will result is excessive bone loss and a more difficult reconstruction. One's goal should be to save bone and save time. The surgeon must be familiar with the implants to know if any special techniques will be required to deal with modularity of the tibial polyethylene, surface coatings and geometry of pegs and stems. The usual steps are to remove the tibial liner if modular, followed by removal of the femoral component, then tibial component. Thin osteotomes are used to loosen the cement prosthesis or bone prosthesis interfaces to be able to remove the implants and not lose bone in the process. Removal of cement mantles around long-stemmed femoral and tibial components can be facilitated by femoral cortical window osteotomies and tibial crest osteotomies.
