Abstract
Objectives
To evaluate and describe the first case in Brazil of a patient undergoing revision surgical treatment with robotic assistance from partial arthroplasty to total knee arthroplasty.
Methods
Description of the follow-up and step-by-step techniques used to prepare and execute revision surgery with robotic assistance in a patient with limiting residual pain after unicompartmental knee arthroplasty.
Results
This report describes the case of a 61-year-old female patient. She had previously undergone Unicompartmental Knee Arthroplasty (UKA) in 2015 at another institution. After investigations to rule out infection or loosening of the UKA components and considering the persistence of symptoms, a conservative treatment approach, involving physiotherapy and infiltrations, was chosen, yielding no significant improvement. Faced with ongoing symptoms, the decision was made to perform a Total Knee Arthroplasty (TKA) with robotic assistance (rTKA). The choice of the Stryker Triathlon system was based on a preoperative computed tomography sent to the United States. The intervention took place on June 15, 2022. Following the Mako protocol, antennas and checkpoints were positioned, and anatomical points were marked under robotic navigation, including the area of the previous UKA. During the surgery, after removing the UKA components and resecting osteophytes, ligament balance was adjusted, achieving equalized gaps in extension and flexion. The patient had an accelerated rehabilitation protocol. She has been monitored for around 18 months with improvements in clinical and functional outcomes.
Conclusion
The use of robotic arm assistance in the revision from unsuccessful UKA to primary TKA is a novel technique that resulted in excellent operative outcomes in this case. Further studies are needed to better define implementation methods and create specific protocols.