It is of great importance to reach a satisfying agreement on the removal of the existing implants and the placement of new ones for revision total knee replacement. This avoids possible complications and technical failures. In many revision replacements, standard medial parapatellar incision is found to be enough. Yet if patellas of tough knees (in particular, cases of knee flexion of <60°) aren`t rotated enough, alternative approaches may be necessary. If surgery is maintained without releasing the extensor mechanism, risk of patellar tendon tear or fracture increases. An ideal surgery entails an easy removal of prosthesis, protection of extensor mechanism, and early range of motion. Various techniques have been defined since a long time. In this article, the methods of tenolysis of extensor mechanism, quadriceps snip, V-Y quadriceps turndown, patellar turndown, tibial tubercle osteotomy, femoral peel, medial epicondylar osteotomy, and banana peel will be examined; their pros and cons will be discussed.