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Success in total knee arthroplasty (TKA) depends on restoring proper joint alignment and implant positioning. While robotic-assisted systems enhance precision in primary TKA, their use in revision TKA is limited due to challenges like bone loss, soft tissue contractures, and metal artifacts. This manuscript presents an imageless robotic navigation technique for revision TKA, eliminating the need for preoperative imaging and allowing intraoperative flexibility. After registering anatomical landmarks and implant removal, the system reassesses anatomy for iterative adjustments based on bone and soft tissue conditions. Unlike traditional canal-referenced methods, this approach aligns components relative to the joint line, enabling individualized positioning. Real-time feedback guides accurate bone cuts and soft tissue balancing. A case example illustrates the procedure. Further studies are needed to confirm long-term clinical benefits.
Braun et al. (Tue,) studied this question.