Robotic Assisted Total Knee Arthroplasty in Arthrofibrosis or the Preoperatively Stiff Knee: A Case Report

Abstract

Total knee arthroplasty (TKA) for arthrofibrosis or preoperatively stiff knees can present a set of difficult problems that challenge both the patient and surgeon. Patients with limited preoperative range of motion (ROM) are inherently at risk for worse outcomes. Prior literature has demonstrated the utility of robotic-assisted TKA (raTKA) regarding gap balancing and coronal deformity, however it has not been previously described in context of the preoperatively stiff knee. Here, we report a case of a patient undergoing primary TKA for severe osteoarthritis with significant preoperative stiffness resulting in severely limited ROM of only 5 degrees. This was performed with the use of a navigated raTKA system in conjunction with dynamic predictive balancing technology. With this method, the knee was balanced through bony cuts without the need for extensive soft tissue releases. This patient had excellent improvement in ROM and KOOS Scores at 3-month follow up. This patient’s early post-operative results demonstrate the potential benefits of utilizing raTKA for preoperative stiff knees and may lay groundwork for future literature.