Utilization of Robotic Arm Assistance for Revision of Primary Total Knee Arthroplasty: A Case Report

Introduction: 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. Case Report: 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. Conclusion: 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. Keywords: Total knee arthroplasty, robotic, revision, total knee arthroplasty.

Comparison the Postoperative Blood Loss in Total Knee Arthroplasty with and without Perioperative Tourniquet Release

Objective: To compare the postoperative blood loss in total knee arthroplasty with and without perioperative tourniquet release. Study Design: Randomized control trial Place & Duration of Study: Department of Orthopaedic, M. Islam Teaching Hospital Gujranwala 1st January 2020 to 31st December 2020. Methodology: Ninety patients of both genders undergoing total knee arthroplasty were included in this study. Patient’s demographics were recorded after written consent. Patients were equally divided into two groups. Group A (45 patients) received total knee arthroplasty with tourniquet while group B (45 patients) received total knee arthroplasty without tourniquet. Postoperative blood loss was measured by suction drain, levels of haemoglobin were examined and compare between two groups. Results: The mean age of the patients in group A was 57.76±2.4 years while in group B it was 58.16±7.8 years. 32 (71.11%) and 34 (75.56%) were males while 13 (28.89%) and 11 (24.44%) were females in group A and B. We observed patients at the three different points and found lower blood loss in patients who received total knee arthroplasty with tourniquet as compared to no tourniquet group (p-value <0.05). No significant difference was observed regarding hemoglobin at 2 hours and significant differences were observed at 24 and 48 hour postoperatively. Conclusion: Tourniquet is useful to decrease loss of blood in patients undergoing total knee arthroplasty. Keywords: Total knee arthroplasty (TKA), Tourniquet, Blood loss

A rare etiology of posterolateral pain subsequent to a total knee arthroplasty

This case report illustrates a very rare problematic after Total Knee Arthro-plasty (TKA), yet that you have to think of if posterolateral pain appears. The postoperative outcome of our patient was initially very good, but pain appeared after 6 weeks, in an atypical mode, that couldn’t be attributed to the most common differential diagnosis. The characteristics of the symptoms directed us to a mechanical cause and the solution finally came up by means of a radiography: the images showed an impingement between one of the tibial tuberosity fixation screw’s head and the fibular neck. What couldn’t be seen on the primary images was an irritating callus, that was detected at 3 months postoperatively. The pain disappeared after surgical removal of the screw. Keywords: Total knee arthroplasty; Posterolateral knee pain; Pain after total knee ar-throplasty; Tibial screw impingement.

IDENTIFICATION OF PREDISPOSING FACTORS FOR RECOVERY OF RANGE OF MOTION OF KNEE AFTER TOTAL KNEE ARTHROPLASTY

BACKGROUND: Knee joint arthroplasty is the standard treatment for severe dysfunction of the knee aiming to make the knee pain free as well as to stabilise it with an appropriate range of motion. Aims and objectives: To assess whether the postoperative functional recovery of range of motion of total knee arthroplasty depends on objective and subjective parameters. MATERIAL AND METHODS: A prospective study comprising of twenty six cases who underwent total knee arthroplasty had been carried out from November 2013 to October 2015, in the in the Orthopaedics Department of IPGMER and SSKM Hospital, Kolkata, West Bengal, India. RESULTS: The mean age group in our study is 35.3 years and 69.2% were females. Left side surgeries were more common (57.7%). Mean fixed flexion deformity decreased significantly from 10.8396 to 0.7692 postoperative 1 year. Mean preoperative extension lag was 2.3077 degrees and postoperative extension lag was 4.0385 degrees. CONCLUSIONS: Total knee arthroplasty is the standard treatment for severe destructive arthritis of the knee with an aim to provide stable, painless and mobile joint. Based on the findings of this study, preoperative arc of flexion, mediolateral laxity and preoperative tibiofemoral varus/valgus angle have a significant influence on the postoperative flexion, which means they are important factors for predicting the outcome range of motion of the knee after a total knee arthroplasty. Keywords: Total Knee Arthroplasty (TKA).