Many treatment options are available to manage bone loss associated with revision total knee arthroplasty. Selection of the best treatment method is based on many factors, including defect size and location and the patient's age, health, and ability to participate in the necessary postoperative rehabilitation. Metaphyseal sleeves and cones appear to be a promising addition in dealing with large, central, contained and noncontained defects. The use of stem extensions in cases of bone deficits is helpful in enhancing fixation and lessening stresses to weakened condylar bone.