Partial revision knee arthroplasty with retention of well-fixed components

Retention of well-fixed and well-aligned component is a technically easier option compared to complete revision in a noninfected revision knee arthroplasty. However, it is very often difficult to decide the right treatment in a particular clinical scenario. In this study, we reviewed the available literature with regard to the role and indications of partial revision, advantages and disadvantages of partial revision over full revision and formulate some treatment algorithm based on the available literature. Our review shows that isolate polyethylene insert exchange is more reliable in a well-aligned and well-fixed knees with early evidence of polyethylene synovitis in a knee that was well functioning for at least 10 years. Polyethylene insert exchange is not reliable in the setting of instability or stiffness. Isolated revision of metal-backed patella is possible in elderly low demand patient with well-fixed femoral component and accessible osteolytic lesion. Outcome can be improved by careful patient selection and performing a synovectomy and polyethylene liner exchange at the time of revision. Isolated tibial component revision is a technically difficult procedure and often associated with poor results and hence should be reserved for well-fixed stemmed femoral component with loose tibia in a poor surgical candidate. Isolated femoral component revision is mainly indicated for femoral component malrotation and is technically easy to perform than isolated tibial component revision.