Worldwide, the number of revisions to total knee arthroplasty procedures is increasing. Revision surgery is a challenging procedure, required for the management of bone loss after removal of the first implant. Although further long-term follow-up studies are needed, the use of cones in revisions of total knee arthroplasty yields reliability in fixation and stability to restore joint lines, especially in challenging surgeries with poor bone stock. The introduction of 3D-printed cones in revision surgery seems to be advantageous for AORI type III bone defects, especially in reducing intraoperative complications and procedure times. The aim of this study is to review the currently available literature to analyse clinical outcomes, complications, and radiographical results with the use of metaphyseal tantalum cones and new 3D-printed cones for the management of bone defects in the revision of total knee arthroplasty.