Objectives The aim of this study is to assess different configurations with stems and metaphyseal cones of the Implantcast GmbH ACS® MB SC knee revision prosthesis on the distribution of internal bone stress in the femur and tibia by means of voxel modeling and finite element analysis. Materials and Methods CT scans from the Visible Human Project were processed to create voxel models of femur and tibia. The components of the modular knee prosthesis were modeled, and virtual surgeries were performed to create bone-prosthesis FE voxel models for four configurations. The bone stresses were compared between the study models and the model without prostheses. New 3D models were created to facilitate the interpretation of the results by practitioners. Results The primary TKA prosthesis configuration presented the lowest bone stress variation post-surgery. Adding metaphyseal cones and stems resulted in a higher decrease in bone stress in the regions near these components and stress concentrations around the stems’ tips. Stress shielding increased when all the components were implanted together. Conclusions Primary total knee arthroplasty prostheses provide a stress distribution closer to the non-prosthetic knee model. The configuration using metaphyseal cones presents a good balance between fixation and stress distribution while stems, although providing excellent fixation, also produce a high stress concentration on their tips. Stress shielding patterns were observed in the distal femur and proximal tibia, especially when both stems and metaphyseal cones were implanted. This could lead to bone remodeling in these regions, losing bone density due to bone resorption.