Mid-resection Workflow for Robotic-assisted Total Knee Arthroplasty in a Stiff Knee.

Introduction: With the growing prevalence of robotic-assisted total knee arthroplasty (RATKA), the significance of effectively addressing complex deformities using this approach is gaining widespread recognition. This article underscores the importance of a novel mid-resection workflow specifically tailored for RATKA in cases with complex deformities. Case Report: A 58-year-old female patient diagnosed with severe osteoarthritis in both knees and a stiff left knee underwent RATKA utilizing a mid-resection workflow. The surgery resulted in favorable intraoperative stability and achieved a satisfactory range of motion. Follow-up at the 1-year post-operative mark demonstrated a range of movement of 110° and a positive functional outcome for the patient. Conclusion: Severe knee arthritis with flexion deformity represents a common condition encountered in surgical practice. The advent of RATKA has provided us with an opportunity to assess and establish the effectiveness of mid-resection workflow in managing such cases.

Isolated Tillaux Fracture in a Skeletally-Mature Patient: A Rare Presentation.

Isolated Tillaux fractures are uncommon injuries that occur due to external rotational forces acting on the ankle joint. They are more commonly seen in adolescents due to the presence of open epiphyses. In adults, isolated Tillaux fractures present as plafond fractures well described with the AO (Arbeitsgemeinschaft für Osteosynthesefragen) Classification as well as Types 1, 2, and 3 according to the degree of articular comminution present. They occur rarely and can be easily missed or misdiagnosed as other ankle injuries. A thorough clinical examination, combined with imaging studies such as X-rays and CT scans, can aid in accurate diagnosis and treatment planning. Management typically involves open reduction and internal fixation, followed by a short period of immobilization and early mobilization with non-weight bearing. We present a case report of a 27-year-old female who presented with an isolated Tillaux fracture of the ankle following a road traffic accident. This type of fracture is typically seen in teenagers and young adults due to the incomplete closure of the growth plate, which makes it more susceptible to injury. The patient underwent open reduction and internal fixation with a contoured three-hole 3.5 mm titanium T-plate, followed by immobilization in a plaster splint for one week. Early mobilization was encouraged with strict non-weight bearing for 8-10 weeks. Follow-up at 12 weeks revealed complete union at the fracture site, with the patient being asymptomatic except for minimal pain and mild restriction in dorsiflexion.