Every person’s anatomy is unique. When it comes to hip and knee replacement surgery, using Mako robotic arm assisted technology gives the orthopaedic surgeon more information about your anatomy which means they can very accurately plan your surgery and therefore cut away less of your bone and damage less of your other soft tissues.

There are some important benefits associated with preserving as a much of your healthy bone and soft tissue as possible. These include: minimal blood loss, faster recovery times, a shorter hospital stay, less post-operative pain and possibly a smaller scar.

Let’s take a look at how it works.

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How Mako robotic arm assisted surgery works

Pre-surgery planning

Before surgery you will have a CT scan of your joint – either hip or knee– and from this the Mako system will develop a 3D virtual model of your joint. Your surgeon can then section and use this model to assess how severe your arthritis is, what your bone structure and surrounding soft tissue is like and determine the unique natural alignment of your joint.

Your surgeon can then create a personalised surgical plan showing the optimal size, placement and alignment of the prosthetic implant. All of this takes place before you even reach the operating table.

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During surgery

It’s important to realise that Mako robotic arm assisted technology doesn’t replace the surgeon’s skill but it complements and enhances it.

During surgery, the robotic arm is used to help the surgeon remove diseased bone and cartilage from the damaged joint. The surgical plan is used to guide this process with absolute precision. Feedback from the system helps the surgeon to stay within clearly defined boundaries so that no healthy bone or tissue is inadvertently removed.

However, there is also a facility within the Mako system to provide intra-operative real-time data. This allows the surgeon to assess the movement and tension of your new joint as it is being trialled and thereafter implanted and, if necessary, to make minute adjustments to the surgical plan. In the long-term even fractional adjustments can make a difference to the comfort and functionality of your replacement joint, so this level of flexibility helps to achieve optimum results.

Once the diseased bone and tissue have been removed, Mako is used to guide the implant into place. Again, the level of precision achieved during this process can make a significant difference to the long-term performance of your joint, as even fractional misalignment of the joint can cause discomfort and loss of function.

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Research into Mako robotic arm assisted surgery

A clinical study published by Bell et al. in 2016 considered the Mako system’s accuracy. During a randomised controlled trial of 120 patients, those receiving a partial knee replacement using the Mako system were compared to patients having the same procedure using conventional surgery. Comparisons were made between the two groups in terms of the pre-operative plan of femoral and tibial component positioning against the actual alignment achieved. The results showed more accurate component positioning in the group that had undergone robotic-arm assisted surgery. Researchers concluded that the Mako system more consistently placed partial knee replacement implants in accordance with the pre-operative plan.

The results were corroborated by another study at University College Hospital in London by Kayani et al (2018). It found that Mako patients had significantly more accurate placement of femoral and tibial implants during partial knee replacement surgery, compared to conventional surgery. They also had more accurate recreation of the knee’s mechanical alignment, posterior tibial slope and joint line height.

If you have severe joint pain and are considering hip or knee joint replacement surgery, talk to us about the options, including Mako robotic arm assisted surgery.

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Robotic arm assisted joint replacement | Cambridge