The technique for revising a total joint arthroplasty is presented, with particular attention given to the initial exposure and the preparation of the distal femur and proximal tibia. The exposure is difficult in many cases. The quadriceps turndown technique, originally described by Coonse and Adams and modified by Insall, is presented. This technique greatly facilitates exposure and enables the distal femur and proximal tibia to be dissected free from overlying scar tissue. The technique of skeletonization of the bones is also presented. This technique provides adequate assessment of the existing bone stock prior to reimplantation of a new total knee replacement. These techniques have been successfully utilized in over 250 revision total joint arthroplasties at the Knee Service at The Hospital for Special Surgery.
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Windsor et al. (1988) studied this question.