Robotic Joint Replacement

The Mako robot is a great piece of orthopaedic technology. It's the most evidence supported orthopaedic robot in the world, with over 1 million joints implanted, making it one of the market leaders for multiplatform orthopaedic robotics.

As a multiplatform robot, it means it can do numerous tasks, rather than being only able to do one type of joint replacement. Currently it is able to help surgeons perform Total hip, Total knee and partial knee replacements, with software for shoulder replacements available in 2025, and work being done on ankle replacements for the future.

First of all we get a CT scan so the robot understands the exact bone contours of your personal joint, as well as other aspects such as how your pelvis moves between sitting and standing, as well as the centre point of your hip and ankle. Next the robotic software makes a 3 dimensional model that your surgeon and the Mako Product Specialist position the implants on, making precise assessments on where the bone is and where the implants need to be placed. During surgery pins are placed in the bone and ‘arrays’ are placed so that the robot knows where the joint is in space, and several marks are checked inside the joint with the robot to ensure your joint exactly matches up with the robots 3D image. Once the robotic image and the live image match up, fine adjustments are made to the plan as we balance the ligaments, and then the robot is brought in to make the extremely accurate cuts. The robot is then used to either position the implant or make final checks, and once all is confirmed the robot is removed and the wound is closed.

Data is constantly being collected and published on this technology to establish its benefits, and as more cases are being done, the more literature we have available. For hips there is evidence suggesting that the virtual planning and precise cup placement can reduce dislocations, as well as helping get accurate leg length measurements. For all joints there are articles showing reduced pain, less time in hospital, quicker rehabilitation, very accurate implant placement, all of which may lead to greater patient satisfaction. It seems that because the bone removal by the robot has very controlled boundaries, only the essential bone is removed which minimises trauma and soft tissue damage. Also the incisions can be smaller as the robot knows where the bone is in space.

Overall it makes this a very exciting time in orthopaedics! Not only do we use tried and trusted implants, we now have the advanced robotic technology with which to place them. The next leap in orthopaedic development is reversing arthritis by growing new cartilage, but until that development comes and joint replacements are required, this technology is a way of ensuring we hit the accuracy bullseye with our joint replacements.