Steelman Kevin, Carlson Kyle, Ketner Andrew
Department of Orthopaedic Surgery, Harper University Hospital, Detroit, Michigan, United States.
Department of Orthopaedic Surgery, Huron Valley-Sinai Hospital, Commerce Township, Michigan, United States.
J Orthop Case Rep. 2021 Aug;11(8):50-54. doi: 10.13107/jocr.2021.v11.i08.2362.
With increasing numbers of knee arthroplasty procedures being performed, revision total knee arthroplasty (TKA) remains a challenge to orthopedic surgeons. The use of robotics in primary joint arthroplasty is also increasing due to better technology and surgeon familiarity. Robotic arms have the ability to execute bone cuts within 1 mm of a preoperative plan, can measure soft tissue gap tension, and can plan femoral and tibial augments and rotation. The use of robotic arm assistance for revision TKA, however, has not been documented in the literature.
We present a case describing a novel technique in which the Mako robot (Stryker, Ft. Lauderdale, FL) was utilized for revision of a failed primary TKA secondary to aseptic loosening. The patient is a 68-year-old Caucasian male who underwent right revision TKA with robotic assistance. Stryker Triathlon TS implants were utilized with the use of both femoral and tibial cones and medial and lateral posterior femoral augments. He had satisfactory component alignment based on postoperative radiographs, and excellent clinical outcomes 6 months postoperatively.
The use of robotic arm assistance in revision TKA for failed primary TKA is a novel technique and resulted in excellent operative outcomes in this case. Further study should be done to confirm its use in revision TKA.
随着膝关节置换手术数量的增加，翻修全膝关节置换术（TKA）对骨科医生来说仍然是一项挑战。由于技术的进步和外科医生对其的熟悉程度提高，机器人技术在初次关节置换术中的应用也在增加。机器人手臂能够在术前计划的1毫米范围内进行截骨，可以测量软组织间隙张力，并可以规划股骨和胫骨的增大及旋转。然而，文献中尚未记载使用机器人手臂辅助进行翻修TKA的情况。
我们介绍了一个病例，描述了一种新技术，即使用Mako机器人（史赛克公司，佛罗里达州劳德代尔堡）对因无菌性松动导致初次TKA失败的患者进行翻修。患者是一名68岁的白人男性，在机器人辅助下接受了右膝翻修TKA。使用了史赛克Triathlon TS植入物，包括股骨和胫骨锥体以及股骨内外侧后髁增大装置。根据术后X光片，假体排列满意，术后6个月临床效果良好。
在因初次TKA失败而进行的翻修TKA中使用机器人手臂辅助是一种新技术，本病例取得了良好的手术效果。应进行进一步研究以证实其在翻修TKA中的应用。
