Mako SmartRobotics™

We understand that knowing what to expect from your joint replacement experience is important to you. As you are reading through this material, please reach out to us to discuss if you have additional questions.

Each patient is unique and can experience joint pain for different reasons. It’s important to talk to us about the reason for your joint pain so you can understand the treatment options available to you. Pain from arthritis and joint degeneration can be constant or come and go, occur with movement or after a period of rest, or be located in one spot or many parts of the body. It is common for patients to try medication and other conservative treatments to treat their knee or hip pain. If you haven’t experienced adequate relief with those treatment options, you may be a candidate for Mako SmartRobotics™ for Total Knee, Total Hip, or Partial Knee replacement.

How Mako SmartRobotics™ works

Mako SmartRobotics™ is an innovative solution for many suffering from painful arthritis of the knee or hip. Mako uses 3D CT-based planning software so your surgeon can know more about your anatomy to create a personalized joint replacement surgical plan. This 3D model is used to pre-plan and assist your surgeon in performing your joint replacement procedure.

In the operating room, your surgeon follows your personalized surgical plan while preparing the bone for the implant. The surgeon guides Mako’s robotic arm within the predefined area, and Mako’s AccuStop™ technology helps the surgeon stay within the planned boundaries that were defined when the personalized pre-operative plan was created. By guiding your doctor during surgery, Mako’s AccuStop™ technology allows your surgeon to cut less by cutting precisely what’s planned1-3 to help protect your healthy bone.4-8

It’s important to understand that the surgery is performed by an orthopaedic surgeon, who guides Mako’s robotic arm during the surgery to position the implant in the knee and hip joints. Mako SmartRobotics™ does not perform surgery, make decisions on its own or move without the surgeon guiding it. Mako SmartRobotics™ also allows your surgeon to make adjustments to your plan during surgery as needed.

Total knee vs. partial knee replacement

Based on the severity of the arthritis in the knee, total or partial knee replacement may be recommended by a surgeon. Both procedures involve the orthopaedic surgeon guiding Mako’s robotic arm to remove diseased bone and cartilage.

• Mako SmartRobotics™ for Partial Knee replacement is a treatment option for adults living with early-to-midstage osteoarthritis (OA) that has not yet progressed to all three compartments of the knee. Depending on where the arthritis affects the knee, patients may have an implant inserted in any of the following areas:
  • In a unicondylar knee replacement, only one area (or compartment) of the joint is replaced.
  • A patellofemoral knee replacement replaces the kneecap (or patella) and the grove at the lower end of the thighbone (or femur).
  • A bicompartmental knee replacement affects two compartments of the knee – the inside (medial) and the knee cap.

• In comparison, Mako SmartRobotics™ for Total Knee replacement is a treatment option for adults living with mid to late-stage osteoarthritis of the knee. With a Mako Total Knee replacement, the entire knee joint is replaced, and the surgeon inserts a Triathlon Total Knee implant. With over a decade of clinical history, Triathlon knee replacements are different than traditional knee replacements because they are designed to work with the body to promote natural-like circular motion.9-11
• Mako SmartRobotics™ for Total Hip replacement is intended for patients who suffer from noninflammatory or inflammatory degenerative joint disease (DJD). Some forms of DJD include osteoarthritis (OA), post-traumatic arthritis, rheumatoid arthritis (RA), avascular necrosis (AVN) and hip dysplasia.

With Mako, we can provide each patient with a personalized surgical experience based on their specific diagnosis and anatomy.  Using a virtual 3D model, Mako allows surgeons to create each patient’s surgical plan pre-operatively before entering the operating room. During surgery, we can validate that plan and make any necessary adjustments while guiding the robotic-arm to execute that plan. It’s exciting to be able to offer this transformative technology across the joint replacement service line to perform total knee, total hip and partial knee replacements.

Meet Mako! from Baptist Health on Vimeo.

The Mako Total Knee application is a knee replacement treatment option designed to relieve the pain caused by joint degeneration due to osteoarthritis. Through CT-based 3D modeling of bone anatomy, surgeons can use the Mako System to create a personalized surgical plan and identify the implant size, orientation and alignment based on each patient’s unique anatomy. The Mako System also enables surgeons to virtually modify the surgical plan intra-operatively and assists the surgeon in executing bone resections.

Healthy Knee

Diseased Knee

Implanted Knee

The Mako Partial Knee application is a treatment option designed to relieve the pain caused by joint degeneration due to osteoarthritis that has not yet progressed to all three compartments of the knee. Following the personalized pre-operative plan, the surgeon guides the robotic arm during bone preparation to execute the pre-determined surgical plan and position the implant. By selectively targeting only the part of the knee damaged by osteoarthritis, surgeons can resurface the diseased portion of the knee, while helping to spare the healthy bone and ligaments surrounding the knee joint. Studies have shown robotic-arm-assisted partial knee replacement to be two to three times more accurate than manual partial knee replacement procedures.[i],[ii],[iii]

The Mako Total Hip application is a treatment option for adults who suffer from degenerative joint disease of the hip. During surgery, the surgeon guides the robotic arm during bone preparation to prepare the hip socket and position the implant according to the pre-determined surgical plan.  In cadaveric studies, Mako total hip replacement acetabular cup placement has been shown to be four times more accurate and reproducible than manual total hip replacement procedures.

IMPORTANT INFORMATION

Knee & hip replacements

Knee and hip replacement is intended for use in individuals with joint disease resulting from degenerative and rheumatoid arthritis, avascular necrosis, fracture of the neck of the femur or functional deformity of the hip.

Knee joint replacement is intended for use in individuals with joint disease resulting from degenerative, rheumatoid and post-traumatic arthritis, and for moderate deformity of the knee.

Joint replacement surgery is not appropriate for patients with certain types of infections, any mental or neuromuscular disorder that would create an unacceptable risk of prosthesis instability, prosthesis fixation failure or complications in postoperative care, compromised bone stock, skeletal immaturity, severe instability of the joint, or excessive body weight.

Like any surgery, joint replacement surgery has serious risks which include, but are not limited to, pain, infection, bone fracture, change in the treated leg length (hip), joint stiffness, hip joint fusion, amputation, peripheral neuropathies (nerve damage), circulatory compromise (including deep vein thrombosis (blood clots in the legs)), genitourinary disorders (including kidney failure), gastrointestinal disorders (including paralytic ileus (loss of intestinal digestive movement)), vascular disorders (including thrombus (blood clots), blood loss, or changes in blood pressure or heart rhythm), bronchopulmonary disorders (including emboli, stroke or pneumonia), heart attack, and death.

Implant-related risks that may lead to a revision of the implant include dislocation, loosening, fracture, nerve damage, heterotopic bone formation (abnormal bone growth in tissue), wear of the implant, metal and/or foreign body sensitivity, soft tissue imbalance, osteolysis (localized progressive bone loss), audible sounds during motion, reaction to particle debris , and reaction to metal ions (ALTR). Knee and hip implants may not provide the same feel or performance characteristics experienced with a normal healthy joint.

The information presented is for educational purposes only. Speak to your doctor to decide if joint replacement surgery is appropriate for you. Individual results vary and not all patients will return to the same activity level. The lifetime of any joint replacement is limited and depends on several factors like patient weight and activity level. Your doctor will counsel you about strategies to potentially prolong the lifetime of the device, including avoiding high-impact activities, such as running, as well as maintaining a healthy weight. It is important to closely follow your doctor’s instructions regarding post-surgery activity, treatment and follow-up care. Ask your doctor if a joint replacement is right for you.

Stryker Corporation or its other divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: AccuStop, Mako, SmartRobotics, Stryker, and Triathlon. All other trademarks are trademarks of their respective owners.

References

1. 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
2. Illgen RL, Bukowski BR, Abiola R, et al. Robotic-assisted total hip arthroplasty: outcomes at minimum two year follow up. Surg Technol Int. 2017;30:365-372.
3. Mahoney O, Kinsey T, Mont M, Hozack W, Orozco F, Chen A. Can computer generated 3D bone models improve the accuracy of total knee component placement compared to manual instrumentation? A prospective multi-center evaluation. Poster presented at: 32nd Annual Congress of the International Society for Technology in Arthroplasty; October 2-5, 2019; Toronto, Canada.
4. Suarez-Ahedo C, Gui C, Martin TJ, Chandrasekaran S, Lodhia P, Domb BG. Robotic-arm assisted total hip arthroplasty results in smaller acetabular cup size in relation to the femoral head size: a matched-pair controlled study. Hip Int. 2017;27(2):147-152. doi:10.5301/hipint.5000418
5. 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
6. Hozack WJ. Multicentre analysis of outcomes after robotic-arm assisted total knee arthroplasty. Bone Joint J:Orthop Proc. 2018;100-B(Supp_12):38.
7. Banks SA. Haptic robotics enable a systems approach to design of a minimally invasive modular knee arthroplasty. Am J Orthop (Belle Mead NJ0. 2009;38(2 Suppl):23-27.
8. Hampp E, Chang TC, Pearle A. Robotic partial knee arthroplasty demonstrated greater bone preservation compared to robotic total knee arthroplasty. Poster presented at: Orthopaedic Research Society Annual Meeting; February 2-5, 2019; Austin, TX.
9. Piazza S. Designed to maintain collateral ligament stability throughout the range of motion. Stryker-Initiated Dynamic Computer Simulations of Passive ROM and Oxford Rig Test. 2003.
10. Wang H, Simpson KJ, Ferrara MS, Chamnongkich S, Kinsey T, Mahoney OM. Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii. J Arthroplasty. 2006;21(8):1193-1199. doi:10.1016/j.arth.2006.02.172
11. Gómez-Barrena E, Fernandez-García C, Fernandez-Bravo A, Cutillas-Ruiz R, Bermejo-Fernandez G. Functional performance with a single-radius femoral design total knee arthroplasty. Clin Orthop Relat Res. 2010;468(5):1214-1220. doi:10.1007/s11999-009-1190-2

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