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I n this sobering report, Barry and colleagues share their results for distal femoral endoprosthetic reconstructions performed for failed TKAs. As might be expected, longer reconstructions are associated with more complications and reoperations; what was perhaps not expected was just how many reoperations and complications occurred after these salvage procedures. The outcomes were quite poor in these patients, and I applaud the authors for their candor. For distal reconstructions, the 5-year infection-free, implant-retention survivorship was 70%; for diaphyseal reconstructions it was only 20%. While the study numbers are limited (further so by loss to followup), and the timeframe quite broad due to the fortunate rarity of these reconstructions, their results provide a sobering snapshot of ‘‘where we are now.’’ To prevent the reader from dismissing these findings as ‘‘just one retrospective study,’’ I would highlight the authors’ point that infection rates as high as 35% and reoperation rates as high as 59% have been reported by others following similar procedures [1, 5].

CORR Insights®: Length of Endoprosthetic Reconstruction in Revision Knee Arthroplasty Is Associated With Complications and Reoperations