Novel Application of an Imageless Robotic System in Simultaneous Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction

Overview

Journal Asia Pac J Sports Med Arthrosc Rehabil Technol

Date 2025 Jan 13

PMID 39802392

Authors

Joshua Yeuk Shun Tran

Rex Wang-Fung Mak

Kevin Ki-Wai Ho

Jonathan Patrick Ng

Cham Kit Wong

Gloria Yan-Ting Lam

Tsz Lung Choi

Michael Tim-Yun Ong

Patrick Shu-Hang Yung

Affiliations

Soon will be listed here.

Abstract

This technical note explores the novel use of an imageless robotic surgical system for simultaneous unicompartmental knee arthroplasty (UKA) and anterior cruciate ligament reconstruction (ACLR). Knee osteoarthritis (OA) and anterior cruciate ligament (ACL) insufficiency are common conditions that traditionally require separate management. The integration of robotic assistance offers enhanced precision in surgical procedures, addressing both medial compartment OA and ACL insufficiency in a single operation. We present a case involving a 47-year-old patient with medial compartment osteoarthritis and complete ACL rupture. The patient underwent a simultaneous robotic-assisted UKA and ACLR using the CORI Surgical System (Smith&Nephew, London, UK). This approach enables accurate tibial tunnel placement and precise soft tissue balancing. The robotic system facilitates real-time gap assessment and balancing, reducing the risk of over- or under-constraint during ACL graft tensioning. The procedure was performed with a standard medial parapatellar approach. Key steps included hamstring autograft harvesting, femoral and tibial tunnel creation, and robotic-assisted implant positioning. Post-operative rehabilitation allowed full weight-bearing by the third week. This case represents the first reported instance of using an imageless robotic system for simultaneous UKA and ACLR, highlighting its potential to standardize and improve results in complex knee surgeries. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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