Robotic Program
Our department has embraced robotics in joint replacement surgery for total knee and hip replacement and partial knee replacement. We have been using the Stryker Mako robot for over 6 years and now have two robots on-site.
Read more below for more information on Mako.
Mako SmartRobotics™ combines
- 3D CT-based planning; and
- Accustop™ haptic technology into one platform that has shown better outcomes for total knee, partial knee and total hip patients, compared to manual surgery.1,2,3
Mako is also the only robotic system in the market using Accustop™ haptic technology for bone preparation. This allows your surgeon to achieve predictable and reproducible outcomes.1,2,3
Mako is the only robotic system that has demonstrated higher accuracy and precision to plan for implant placement and sizing for total knee, partial knee and total hip procedures.4,5,6
Total Hip
Mako SmartRobotics™ allows your surgeon to:
- Know so much more with 3D CT-based planning and functional hip features such as pelvic tilt, virtual range of motion (VROM), and impingement detection.1-3
- Precisely execute a plan with Accustop™ haptic technology whilst using their preferred approach, whether that’s posterior, direct anterior or direct superior.4-8
Partial Knee
Mako uses CT data that is segmented to create a 3D model of the patient’s unique bony anatomy.3,4 The partial knee application allows the surgeon to adjust the implant on the patient’s 3D anatomy virtually, considering:
- osteophytes, cysts, and bony defects;
- The 6 degrees of freedom;
- Implant alignment and fit in all three planes; and
- Key anatomic landmarks such as the transepicondylar axis, posterior condylar axis and the mechanical axis
Total Knee Arthroplasty
20% Dissatisfaction with manual procedures 7,8
Total Knee Arthroplasty (TKA) is an established and successful procedure for the treatment of end-stage knee arthritis.5 Survivorship at 10 years is commonly reported in the 90th percentile.6
However, despite the demonstratable benefits of TKA:
- Reported dissatisfaction rates for TKA are around 20%.7,8
- Inaccuracies in implant positioning and soft tissue balancing have the potential to negatively impact patient outcomes and reduce implant survivorship.9-11
- Instability remains the leading cause of TKA failure 9 and can be attributed to inconsistencies in achieving a well-balanced knee that optimises the function and pain relief for the patient.10
Total Knee
94% Very satisfied or satisfied with Mako 15 Mako SmartRobotics™ combines 3D CT-based planning and AccuStop™ haptic technology into one platform, which in comparison to manual techniques, has been shown in cadaveric and clinical settings to have increased accuracy and precision to plan 1,12,13. Mako TKA has been shown:
- To have a more anatomic reconstruction of component positioning.14
- Promising functional outcomes, with studies reporting patients have experienced improved early function, less pain, and higher patient satisfaction, when compared to manual surgery. 4
St George MAKO trained Orthopaedic Surgeons
Knee
Hip
Mako SmartRobotics™
References:
- Illgen, R, Bukowski, B, Abiola, R, Anderson, P, Chughtai, M, Khlopas, A, Mont, M. Robotic-assisted total hip arthroplasty: Outcomes at minimum two year follow up. Surgical Technology International. 2017 July 25; 30:365-372
- Kayani B, Konan S, Tahmassebi J, Pietrzak JRT, Haddad FS. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. The Bone and Joint Journal. 2018;100-B:930-7.
- Kleeblad LJ, Borus T, Coon T, Dounchis J, Nguyen J, Pearle A. Midterm survivorship and patient satisfaction of robotic-arm assisted medial unicompartmental knee arthroplasty: a multicenter study. The Journal of Arthroplasty. 2018:1-8.
- Anthony I, Bell SW, Blyth M, Jones B et al. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty. J Bone Joint Surg Am. 2016;98-A(8):627-35.
- Hampp EL, Chughtai M, Scholl LY, Sodhi N, Bhowmik-Stoker M, Jacofsky DJ, Mont MA. Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques. J Knee Surg. 2018 May 1.
- Domb B, Redmond J, Louis S, Alden K, Daley R, LaReau J, et al. Accuracy of component positioning in 1980 total hip arthroplasties: a comparative analysis by surgical technique and mode of guidance. The Journalof Arthroplasty. 30(2015)2208-2218.
Total Hip
References:
- Borukhov I, Scholl L, Hampp E, Smith R, Byrd Z. Robotic assisted THA performed by surgeons in fellowship training leads to improved accuracy and precision to plan. Orthopaedic Research Society Annual Meeting. February 8-11, 2020; Phoenix, AZ.
- Lawson JA, Garber AT, Stimac JD, Ramakrishnan R, Smith LS, Malkani AL. Does robotic-assisted total hip arthroplasty improve accuracy of cup positioning? J Hip Surg. 2019;03(04):176-180. doi:10.1055/s-0039-1693480
- Kayani B, Konan S, Thakrar RR, Huq SS, Haddad FS. Assuring the long-term total joint arthroplasty: a triad of variables. Bone Joint J. 2019;101-B(1_Supple_A):11-18. doi:10.1302/0301-620X.101B1.BJJ2018-0377.R1
- Nodzo SR, Chang C-C, Carroll KM, et al. Intraoperative placement of total hip arthroplasty components with robotic-arm assisted technology correlates with postoperative implant position: a CT-based study. Bone Joint J. 2018;100- B(10):1303-1309. doi:10.1302/0301-620X.100B10- BJJ-2018-0201.R1
- Domb BG, Redmond JM, Louis SS, et al. Accuracy of component positioning in 1980 total hip arthroplasties: a comparative analysis by surgical technique and mode of guidance. J Arthroplasty. 2015;30(12):2208-2218. doi:10.1016/j.arth.2015.06.059
- Elson L, Dounchis J, Illgen R, et al. Precision of acetabular cup placement in robotic integrated total hip arthroplasty. Hip Int. 2015;25(6):531-536. doi:10.5301/hipint.5000289
- Domb BG, El Bitar YF, Sadik AY, Stake CE, Botser IB. Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study. Clin Orthop Relat Res. 2014;472(1):329-336. doi:10.1007/s11999- 013-3253-7
- Nawabi DH, Conditt MA, Ranawat AS, et al. Haptically guided robotic technology in total hip arthroplasty: a cadaveric investigation. Proc Ins Mech Eng H. 2013;227(3):302-309. doi:10.1177/0954411912468540
Partial Knee
References:
- Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study. J Bone Joint Surg Am. 2016;98(8):627-635. doi:10.2106/JBJS.15.00664
- Park KK, Han CD, Yang I-H, Lee W-S, Han JH, Kwon HM. Robot-assisted unicompartmental knee arthroplasty can reduce radiologic outliers compared to conventional techniques. PLoS One. 2019;14(12):e0225941. doi:10.1371/ journal.pone.0225941
Total Knee Arthroplasty
References:
- Mistry, J.B., Elmallah, R.K., Chughtai, M., Oktem, M., Harwin, S.F., Mont, M.A. Long-Term Survivorship and Clinical Outcomes of a Single Radius Total Knee Arthroplasty. Surgical Technology International XXVIII.
- Bourne, R.B., Chesworth, B.M., Davis, A.M., Mahomed, N.N., Charron, K.D.J. Patient Satisfaction after Total Knee Arthroplasty: Who is Satisfied and Who is Not? CORR 2010;468: 57–63.
- Noble P.C., Conditt, M.A., Cook, K.F., Mathis, K.B. Patient Expectations Affect Satisfaction with Total Knee Arthroplasty. CORR 2006;453: 35–43.
- McNabb, D.C., Kim, R.H., Springer, B.D. Instability after total knee arthroplasty. J Knee Surg 2015; 28:97–104. doi:10.1055/s-0034-1396080.
- Kim, Y-H., Park, J-W., Kim, J-S., Park, S-D. The relationship between the survival of total knee arthroplasty and postoperative coronal, sagittal and rotational alignment of knee prosthesis. Int Orthop 2014; 38:379–85. doi:10.1007/s00264-013-2097-9.Mason, J.B., Fehring, T.K., Estok, R., Banel, D., Fahrbach, K. Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. J Arthroplasty 2007;22(8):1097–106. doi:10.1016/j. arth.2007.08.001
Total Knee
References:
- Hampp EL, Chughtai M, Scholl LY, et al. Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision to plan compared with manual techniques. J Knee Surg. 2019;32(3):239- 250. doi:10.1055/s-0038-1641729
- Kayani B, Konan S, Pietrzak JRT, Haddad FS. Iatrogenic bone and soft tissue trauma in robotic-arm assisted total knee arthroplasty compared with conventional jig-based total knee arthroplasty: a prospective cohort study and validation of a new classification system. J Arthroplasty. 2018;33(8):2496-2501. doi:10.1016/j.arth.2018.03.042
- Sires JD, Wilson CJ. CT validation of intraoperative implant position and knee alignment as determined by the Mako Total Knee Arthroplasty System. J Knee Surg. Accepted manuscript. Published online March 4, 2020. doi:10.1055/s-0040-1701447
- Kayani B, Konan S, Tahmassebi J, Pietrzak JRT, Haddad FS. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. The Bone and Joint Journal. 2018;100-B:930-7.
- Hamilton, D.F., Burnett, R., Howie, C.R., Patton, J.T., Moran, M., Simpson, A.H., Gaston, P. Implant design influences patient outcome after total knee arthroplasty: a prospective double-blind randomised controlled trial. Bone Joint J 2015;97-B:64–70.
- Mistry, J.B., Elmallah, R.K., Chughtai, M., Oktem, M., Harwin, S.F., Mont, M.A. Long-Term Survivorship and Clinical Outcomes of a Single Radius Total Knee Arthroplasty. Surgical Technology International XXVIII.
- Bourne, R.B., Chesworth, B.M., Davis, A.M., Mahomed, N.N., Charron, K.D.J. Patient Satisfaction after Total Knee Arthroplasty: Who is Satisfied and Who is Not? CORR 2010;468: 57–63.
- Noble P.C., Conditt, M.A., Cook, K.F., Mathis, K.B. Patient Expectations Affect Satisfaction with Total Knee Arthroplasty. CORR 2006;453: 35–43.
- McNabb, D.C., Kim, R.H., Springer, B.D. Instability after total knee arthroplasty. J Knee Surg 2015; 28:97–104. doi:10.1055/s-0034-1396080.
- Kim, Y-H., Park, J-W., Kim, J-S., Park, S-D. The relationship between the survival of total knee arthroplasty and postoperative coronal, sagittal and rotational alignment of knee prosthesis. Int Orthop 2014; 38:379–85. doi:10.1007/s00264-013-2097-9.
- Mason, J.B., Fehring, T.K., Estok, R., Banel, D., Fahrbach, K. Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. J Arthroplasty 2007;22(8):1097–106. doi:10.1016/j. arth.2007.08.001
- Khlopas, A., Sodhi, N., Sultan, A.A., Chughtai, M., Molloy, R.M., Mont, M.A. Robotic arm–assisted Total Knee Arthroplasty. The Journal of Arthroplasty 2018; doi: 10.1016/j.arth.2018.01.060.
- Carroll, K., Nickel, B., Pearle, A., Kleeblad, L.J., Mayman, D.J., Jerabek, S.A., Small Radiographic and Functional Outcomes of Robotic-Assisted Total Knee Arthroplasty at One Year ISTA 31st Annual Congress to be held 10-13 October, 2018.
- Kayani, B., Konan, S., Ayuob, A., Onochie, E., Al-Jabri, T., Haddad, F.S. Robotic technology in total knee arthroplasty: a systematic review. Effort Open Rev. 2019 Oct; 4(10): 611–617