Robotic-Assisted Partial Revision of Total Knee Arthroplasty: First Case Report and Literature Review

Xinguang Wang; Kangpeng Li; Ziyang Dong; Zhencan Han; Yipu Zhang; Yang Li; Zijian Li; Hua Tian

doi:10.1111/os.70343

Orthopaedic Surgery ›› 2026, Vol. 18 ›› Issue (7) :1529 -1541. DOI: 10.1111/os.70343

CASE REPORT

Robotic-Assisted Partial Revision of Total Knee Arthroplasty: First Case Report and Literature Review

Xinguang Wang ¹^,²
, Kangpeng Li ¹^,²
, Ziyang Dong ¹^,²
, Zhencan Han ¹^,²
, Yipu Zhang ¹^,²
, Yang Li ¹^,²
, Zijian Li ¹^,²
, Hua Tian ¹^,²

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Abstract

Background: Revision total knee arthroplasty (rTKA) poses substantial technical challenges. Although robotic assistance has demonstrated efficacy in primary TKA, its application in partial revision procedures remains poorly understood. This study presents a case of robotic-assisted partial rTKA—specifically, isolated tibial component revision using the retained femoral component as a registration reference—and provides a comprehensive review of the current literature.

Case Presentation: A 66-year-old male presented with progressive knee pain 8 years after left TKA. Imaging revealed a well-fixed femoral component but isolated aseptic loosening with posterior tilting of the tibial component. Given the stability of the femoral component, a robotic-assisted partial revision targeting only the tibial component was performed. The robotic system was registered intraoperatively using the well-fixed retained femoral component as the primary reference, enabling accurate spatial orientation despite the altered tibial anatomy. A critical prerequisite for this procedure was implant compatibility between the retained Triathlon femoral component and the planned Triathlon TS revision system. After removal of the loose tibial tray and debridement, robotic-arm guidance was used for precise tibial osteotomy with a 10 mm augment. Postoperative imaging confirmed optimal component positioning. The patient achieved 0°–130° range of motion within 2 weeks, with favorable short-term clinical and radiological outcomes at 1 year follow-up.

Conclusion: This case demonstrates the technical feasibility of robotic-assisted partial TKA revision, with favorable short-term clinical and radiological outcomes at 1 year follow-up. The technique enabled precise osteotomy, balanced gap restoration, and preservation of the well-fixed femoral component. While these preliminary results are encouraging, larger studies with longer follow-up are needed to establish comparative effectiveness and generalizability.

Keywords

knee arthroplasty / partial revision / robot

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Xinguang Wang, Kangpeng Li, Ziyang Dong, Zhencan Han, Yipu Zhang, Yang Li, Zijian Li, Hua Tian. Robotic-Assisted Partial Revision of Total Knee Arthroplasty: First Case Report and Literature Review. Orthopaedic Surgery, 2026, 18 (7) : 1529-1541 DOI:10.1111/os.70343

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