Extensor mechanism insufficiency is a rare but unfortunate event in revision total knee arthroplasty (TKA). This video describes two different techniques used for extensor mechanism reconstruction in revision TKA: reconstruction using a whole extensor mechanism allograft, and the mesh technique described by Hanssen. Postoperatively, the knee is immobilized in a resin cast in full extension for 6 to 8 weeks, and toe-touch weight bearing is allowed. After the resin cast is removed, progressive full weight bearing is allowed in 4 to 6 weeks, and progressive range of motion recovery is permitted. This technique is mainly indicated for chronic patellar fractures or nonunion, patellectomies, or failed reconstructions with allograft. Contraindications for this technique are active infection, inadequate skin coverage, and severe medical comorbidities. A good tension of the graft is mandatory to obtain good results and a low extensor lag rate.