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General Orthopaedics

Robotic-Assisted Bi-Unicompartmental Knee Arthroplasty

International Society for Technology in Arthroplasty (ISTA)



Abstract

Introduction:

This is a case report of a 78 year old male who underwent outpatient mini-incision medial UKA using the haptic robotic guidance. The patient subsequently suffered a traumatic lateral meniscus tear and underwent a lateral compartment UKA with the same robotic system instead of converting to a total knee replacement at one year post op and is now 2 years post op on the lateral side as well.

Methods:

The patient is a 74 year old male with a BMI of 27, suffering from OA of the right knee. He had a previous TKA on his left side by another surgeon that was followed with a lateral release by still another surgeon with fair to good satisfaction currently; however he did not want another TKA. He had multiple aspirations and injections of corticosteroids for arthritic effusions on his right knee that were moderate to severe and painful. On 7/6/2010 he underwent a right medial UKA using with robotic guidance. The patient had a subsequent injury to his lateral meniscus causing pain for which multiple options were discussed with the patient. The informed patient chose to have a lateral compartment arthroplasty. On 6/21/2011 a lateral compartment UKA was performed on the same patient's right knee through a second mini-lateral incision again using robotic guidance.

Results:

The patient is now 35 months after his right medial UKA and 24 months after his right lateral UKA. His function is excellent, his range of motion is excellent at 0–135° compared to 120° pre-operatively, his satisfaction is excellent and he has no self-reported limitations with his right knee.

Conclusions:

The complexity of patient-specific planning, the ability to adjust that plan intra-operatively to optimize kinematics and the safety of implementing this plan using haptically guided robotic bone resection provides many advantages in partial knee arthroplasty. In the case presented here, a post-operative lateral meniscal injury subsequent to medial UKA in the same knee was treated with a lateral UKA. Accurate placement of the components and balancing the knee with the existing medial UKA provided by the robotic platform was critical to the excellent post-operative outcomes.


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