Novel Application of an Imageless Robotic System in Revision Total Knee Arthroplasty - Unicompartmental Knee Arthroplasty Conversion, 1-Stage Revision, and 2nd-Stage Revision

Sep 30, 2026

Revision total knee arthroplasty (TKA) is technically demanding because infection, component failure, and bone loss complicate reconstruction. The use of CORI imageless robotic systems in revision TKA remains insufficiently investigated. This study assesses imageless robotic utility across three complex revision scenarios: unicompartmental knee arthroplasty conversion, one-stage revision, and second-stage revision. Results from a prospective case series show improved clinical outcomes with enhanced alignment and gap balancing.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Introduction

Materials and Methods

Results

The International Journal of Medical Robotics and Computer Assisted Surgery - ORIGINAL ARTICLE OPEN ACCESS Novel Application of an Imageless Robotic System in Revision Total Knee Arthroplasty: Unicompartmental Knee Arthroplasty Conversion, 1‐Stage Revision, and 2nd‐ Stage Revision Joshua Yeuk Shun Tran1 | Rex Wang‐Fung Mak2 | Kevin Ki‐Wai Ho1,3 | Jonathan Patrick Ng2 | Cham Kit Wong4 | Gloria Yan‐Ting Lam4 | Tsz Lung Choi4 | Michael Tim‐Yun Ong1,3 | Patrick Shu‐Hang Yung1,3 1Chinese University of Hong Kong, Hong Kong, China | 2Prince of Wales Hospital, Hong Kong, China | 3CUHK Medical Centre, Hong Kong, China | 4Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China Correspondence: Michael Tim‐Yun Ong ([michael.ong@cuhk.edu.hk](michael.ong@cuhk.edu.hk)) Received: 8 February 2025 | Revised: 29 November 2025 | Accepted: 30 December 2025 Keywords: imageless robotic systems | intraoperative mapping | revision total knee arthroplasty | robotic surgery | unicompartmental knee arthroplasty ABSTRACT Introduction: Revision total knee arthroplasty (TKA) presents significant challenges due to factors such as infection, component failure, and bone loss. The application of the CORI imageless robotic systems in revision TKA remains underexplored. This study evaluates the utility of the imageless robotic system in three complex revision scenarios: unicompartmental knee arthroplasty conversion, one‐stage revision, and second‐stage revision. Methods: A prospective case series of patients undergoing revision ofTKA was conducted. Intraoperative surface mapping and soft tissue tension guided surgical planning. Standardised perioperative protocols and rehabilitation were applied. Results: All patients demonstrated improved outcomes, with Knee Society Scores ranging from 90 to 95 and functional scores from 50 to 80 within two to six months postoperatively. Enhanced alignment and gap balancing were consistently achieved. Discussion: The imageless system facilitated precise intraoperative assessment and standardised techniques in revision TKA, supporting its potential to improve clinical outcomes. Further studies are warranted to establish long‐term benefits. 1 | Introduction Revision total knee arthroplasty (TKA) is a common procedure with various causes including infection, mechanical complications, and dislocation [1] . The approach to management and treatment of revision total knee arthroplasty varies according to the failure mechanism with the focus on minimising subsequent complications [2] . Another cause for revision TKA is unicompartmental knee arthroplasty (UKA) conversion. It is common for UKA knees to fail and thus require conversion to total knee arthroplasty (TKA) due to causes such as disease progression, component loosening or sinking, and unexplained pain [3–5] . Challenges of UKA conversion include varied UKA implants and alignments, intra‐articular scarring, implant and cement removal, and loss of bony landmarks post‐UKA [6, 7] . Despite the frequent need for conversion, there is yet to be a widely accepted consensus on the surgical techniques [8] . Imageless robotic systems may provide a platform for standardised techniques as they create an accurate intraoperative virtual 3D model via surface mapping and are able to obtain the operative soft tissue tension by applying varus and valgus stress | Joshua Yeuk Shun Tran and Rex Wang‐Fung Mak are co‐first authors. | | --- | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2026 The Author(s) . The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd. | The International Journal of Medical Robotics and Computer Assisted Surgery, 2026; 22:e70135 1 of 9 [https://doi.org/10.1002/rcs.70135](https://doi.org/10.1002/rcs.70135) throug

FAQs

Why is revision total knee arthroplasty challenging?

Revision TKA is difficult due to infection, component failure, and bone loss, which can affect reconstruction planning and outcomes.

What revision scenarios does the study evaluate?

It evaluates imageless robotic use in unicompartmental knee arthroplasty conversion, one-stage revision, and second-stage revision.

What were the reported outcomes after using the imageless robotic system?

Patients showed improved outcomes, including Knee Society Score improvements and functional score gains, alongside enhanced alignment and gap balancing within months after surgery.

Sep 30, 2026

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