Improved Perioperative Outcomes in Robotic-Assisted Revision Total Knee Arthroplasty

This study compares short-term outcomes of robotic-assisted revision total knee arthroplasty (RA-rTKA) to conventional rTKA. We hypothesize that RA-rTKA will accelerate gains in range of motion and time to ambulation postoperatively.

This is a retrospective case-control study reviewing consecutive rTKA performed by a single surgeon between 2017 and 2024. rTKA cases performed prior to 2022 were compared to RA-rTKA performed from 2022 through present day. Revisions for periprosthetic joint infection or fracture were excluded. The primary outcome was hospital length of stay. Secondary outcomes included physical therapy (PT) metrics, blood loss, surgical time, and complications. Data collected included demographics, surgical and implant data, in-hospital PT progress, and outcomes through a minimum of 1 year.

Sixty-six revision cases (42 rTKA and 24 RA-rTKA) were included with an average age of 67.7 years. Etiologies included loosening (42), second-stage reimplantation (12) after infection eradication, polyethylene wear (6), instability (6), and other etiologies (6). RA-rTKA case time averaged 27 minutes less than conventional; P = .18. The RA-rTKA cohort ambulated further on postoperative day 1 compared to the rTKA group (166.3 vs 87.2 feet; P = .01), was cleared by PT for discharge sooner (2.1 vs 3.1 days; P < .01), and had a shorter hospital length of stay (2.5 vs 3.6 days, P = .01). While all patients in both cohorts achieved at least 110° knee flexion by 6 weeks, RA-rTKA patients demonstrated significantly more knee flexion (119° vs 110°; P = .05). At a minimum of 1-year follow-up, no RA-rTKA patients required rerevisions, compared to 2 rTKA patients.

In this study, RA-rTKA showed improved ambulation in the immediate postoperative period, decreased hospital length of stay, and overall increased knee range of motion. These improvements were realized without increases in complications or operative time.