Introducing Mako SmartRobotics

Mako SmartRobotics combines three key components: 3D CT-based planning, AccuStop haptic technology, and insightful data analytics, into one platform that has shown better outcomes for your total knee, total hip and partial knee patients. 1,2,3

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Mako SmartRobotics Overview | Stryker

KNOW MORE

It all starts with a CT scan that creates a 3D image of your patient’s unique anatomy. This information you’ve never had before allows you to create your patient’s plan and assess and balance the joint.

Mako Total Knee

A distinct, prospective, consecutive series, single-surgeon study comparing patients undergoing conventional jig-based total knee replacement versus Mako Total Knee surgery (40 patients) concluded that Mako Total Knee with Triathlon was associated with: Less need for opiate analgesics (p<0.001), less time to hospital discharge (26% reduction in LOS), less need for in-patient physical therapy sessions (p<0.001), and less postoperative pain (p<0.001).4

Mako Partial Knee

At minimum 3-year follow-up, Mako Partial Knee patients (n=51) showed no implant failure or implant-related complication or revision surgery, as well as excellent overall patient satisfaction for 96.1% of patients (patients reported very satisfied or satisfied).5

Mako Total Hip

In a cadaveric study, Mako Total Hip was significantly more accurate to plan than manual implantation in reproducing COR and cup orientation.6

CUT LESS

Using everything the CT scan helps you to know about your patient, Mako AccuStop haptic technology guides you to cut what’s planned precisely for each patient.1,14,15 For some patients, that means preserving soft tissue; for others, that means saving healthy bone.7,8,9,10

Mako Total Knee

A prospective, consecutive series, single-surgeon study comparing patients undergoing conventional jig-based total knee replacement versus Mako Total Knee surgery (30 patients), concluded that Mako Total Knee with Triathlon was associated with less bone and soft tissue damage (p<0.05).8

Mako Partial Knee

In a single surgeon study comparing consecutive Mako Partial Knee (n=73) vs. manual Oxford uni (n=73), Mako Partial Knee patients demonstrated: reduced post-op pain (p<0.001), decreased analgesia requirements (p<0.001), shorter time to straight leg raise (p<0.001), decreased number of PT sessions (5 vs. 9, p<0.001), improved max knee flexion at discharge (p<0.001), and reduced mean time to hospital discharge (29 hours).11

Mako Total Hip

In a controlled, match-paired study, using acetabular head size as an approximate surrogate measure of acetabular bone resection, results suggested greater preservation of bone stock using Mako Total Hip compared to manual surgery.12

CLINICAL STUDIES

Mako Total Knee key clinical studies
Accuracy to plan

 

Title

Robotic-arm assisted total knee arthroplasty more accurately restored the posterior condylar offset ratio and the Insall-Salvati Index compared to the manual technique; a cohort-matched study

Journal

Surgical Technology International

Year

2019

Author(s)

Sultan AA, Khlopas A, Sodhi N, Bhowmik-Stoker M, Chen A, Orozco F, Kolisek F, Mahoney O, Smith LS, Malkani A, Molloy RM, Mont MA

Institutions

Cleveland Clinic, Cleveland, Ohio; Rothman Institute, Philadelphia, Pennsylvania; OrthoIndy, Indianapolis, Indiana; Athens Orthopaedic Clinic, Athens, Georgia; Shea Orthopedic Group, Louisville, Kentucky; Lenox Hill Hospital, New York City, New York

Conclusion

“Patients who underwent TKA using robotic-arm assisted technology had smaller mean differences in PCOR which had been previously shown to correlate with better joint ROM at 1-year following surgery. In addition, these patients were less likely to have values outside of normal Insall-Salvati Index, which meant they may be less likely to develop patella baja, a condition in which the patella would impinge onto the patellar component, potentially leading to restricted flexion and overall ROM.”

 

 

Title

Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision to plan compared with manual techniques

Journal

Journal of Knee Surgury

Year

2018

Author(s)

Hampp EL, Chughtai M, Scholl LY, Sodhi N, Bhowmik-Stoker M, Jacofsky DJ, Mont MA

Institutions

Cleveland Clinic; Lenox Hill Hospital; CORE Institute

Conclusion

In a cadaveric study that compared RA-TKA to manual TKA (M-TKA), “RA-TKA bone cuts were as or more accurate to plan based on nominal median values in 11 out of 12 measurements. RA-TKA bone cuts were more precise to plan in 8 out of 12 measurements. RA-TKA final component positions were as or more accurate to plan based on median values in five out of five measurements. RA-TKA final component positions were more precise to plan in four out of five measurements… When compared with M-TKA, RA-TKA demonstrated more accurate and precise bone cuts and implant positioning to plan.”

Mako Total Knee key clinical studies
Soft tissue

 
Title

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

Journal

Journal of Arthroplasty

Year

2019

Author(s)

Kayani B, Konan S, Pietrzak JRT, Haddad FS

Institution(s)

University College Hospital, London, UK; Princess Grace Hospital, London, UK

Conclusion

“There was reduced bone and periarticular soft tissue injury” in patients who underwent RA-TKA compared to conventional TKA.

Mako Total Knee key clinical studies
Outcomes

 

Title

Do total knee arthroplasty surgical instruments influence clinical outcomes? A prospective parallel study of 150 patients

Journal

Presented at ORS

Year

2019

Author(s)

Bhowmik-Stoker M, Faizan A, Nevelos J, Tippett B, Clark G

Institution(s)

St. John of God, Perth, Australia

Conclusion

Compared to computer navigated TKA, patients who received RA-TKA had significantly improved post-op pain, reduced total morphine consumption, and a reduced length of stay.

 

 

Title

Multicenter analysis of outcomes after robotic-arm assisted total knee arthroplasty

Journal

Presented at the Knee Society Meeting

Year

2018

Author(s)

Hozack W, Chen A, Khlopas A, Mahoney O, Mont M, Murray T, Orozco F, Higuera Rueda C, Stearns K

Institution(s)

Rothman Institute; Brigham and Women’s Orthopaedic Center; Cleveland Clinic; Athens Orthopaedic Clinic; Lenox Hill Hospital

Conclusion

The data indicated RA-TKA patients had greater improvement in their functional activity walking and standing scores at both 4-6 weeks and 6 months follow-up (p=0.019 and p=0.017, respectively) when compared to conventional TKA patients. Additionally, RA-TKA patients had higher overall functional activity improvements at 1-year follow-up (p=0.020).

 

 

Title

Patient satisfaction outcomes after robotic-arm assisted total knee arthroplasty: a short-term evaluation

Journal

Journal of Knee Surgury

Year

2017

Author(s)

Marchand RC, Sodhi N, Khlopas A, Sultan AA, Harwin SF, Malkani AL, Mont MM

Institution(s)

Ortho Rhode Island, Wakefield, RI; Cleveland Clinic, Cleveland, OH; Mount Sinai West Hospital, New York; KentuckyOne Health, Louisville, KY

Conclusion

In a single-surgeon study of 28 cemented RA-TKAs, the RA-TKA cohort had a significantly lower mean pain score and greater patient satisfaction than the manual TKA cohort. The results from this study showed that patients who underwent RA-TKA demonstrated better overall patient satisfaction and functional outcome scores.

Mako Total Knee key clinical studies

Cost

 

Title

Health care utilization and payer cost analysis of robotic arm assisted total knee arthroplasty at 30, 60, and 90 days

Journal

Journal of Knee Surgury

Year

2019

Author(s)

Mont MA, Cool C, Gregory D, Coppolecchia A, Sodhi N, Jacofsky D

Institution(s)

Lenox Hill Hospital; Baker Tilly; The CORE Institute

Conclusion

RA-TKA patients had overall lower average 90-day EOC cost to payer (Medicare) compared to conventional TKA. Cost savings were driven by: reduced index facility costs, lower LOS, discharge destinations, and decreased readmissions.

Mako Partial Knee key clinical studies
Accuracy to plan

 

Title

Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study

Journal

Journal of Bone and Joint Surgery

Year

2016

Author(s)

Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M

Institution(s)

Glasgow Royal Infirmary, UK

Conclusion

Mako Partial Knee demonstrated improved accuracy of component positioning to plan compared with conventional surgical techniques (Oxford).

Mako Partial Knee key clinical studies
Survivorship

 

Title

Clinical outcomes of robotically assisted UKAs at 3 years follow-up

Journal

Presented at The Partial Knee Meeting (Bruges, Belgium)

Year

2018

Author(s)

Catani, F

Institution(s)

Universita degli Studi di Modena e Reggio-Emilia, Italy

Conclusion

Mako Partial Knee survivorship at 3-year follow-up was 99.2% for medial UKA (n=388) and 100% for lateral UKA (n=67).

Mako Partial Knee key clinical studies
Outcomes

Title

An assessment of early functional rehabilitation and hospital discharge in conventional versus robotic-arm assisted unicompartmental knee arthroplasty

Journal

Bone Joint Journal

Year

2018

Author(s)

Kayani B, Konan S, Tahmassebi J, Rowan FE, Haddad FS

Institution(s)

University College London Hospital; Princess Grace Hospital

Conclusion

In a single surgeon study comparing consecutive Mako Partial Knee (n=73) vs. manual Oxford uni (n=73), Mako Partial Knee patients demonstrated: reduced post-op pain (p<0.001), decreased analgesia requirements (p<0.001), shorter time to straight leg raise (p<0.001), decreased number of PT sessions (5 vs. 9, p<0.001), improved max knee flexion at discharge (p<0.001), and reduced mean time to hospital discharge (29 hours).

 

 

Title

Outcomes of robotic-arm assisted medial unicompartmental knee arthroplasty: minimum 3-year follow-up

Journal

European Journal of Orthopaedic Surgery & Traumatology

Year

2019

Author(s)

Dretakis K, Igoumenou VG

Institution(s)

Hygeia Hospital, Athens, Greece; National and Kapodistrian University of Athens, Greece

Conclusion

At minimum 3-year follow-up, Mako Partial Knee patients (n=51) showed no implant failure or implant-related complication or revision surgery, as well as excellent overall patient satisfaction for 96.1% of patients (patients reported very satisfied or satisfied).

 

 

Title

Robotic-arm assisted vs. conventional unicompartmental knee arthroplasty: the 2 year clinical outcomes of a randomized controlled trial

Journal

J Arthroplasty

Year

2018

Author(s)

Gilmour A, MacLean AD, Rowe PJ, Banger MS, Donnelly I, Jones BG, Blyth M

Institution(s)

Glasgow Royal Infirmary, Scotland, UK; University of Strathclyde, Scotland, UK

Conclusion

For more active patients, Mako Partial Knee patients had significantly better outcomes at 2 years compared to manual Oxford uni patients as measured by the AKSS (p=0.017), OKS (p=0.036), FJS (p=0.017), and Stiffness VAS (p=0.019).

 

 

Title

Robotic-arm assisted versus conventional unicompartmental knee arthroplasty: exploratory secondary analysis of a randomized controlled trial

Journal

Bone and Joint Research

Year

2017

Author(s)

Blyth MJG, Anthony I, Rowe P, Banger MS, MacLean A, Jones B

Institution(s)

University of Strathclyde, Glasgow, UK

Conclusion

Mako Partial Knee patients reported 55.4% lower post-op pain compared to manual patients (Oxford) from day one to week eight (p=0.04) and had better AKSS scores compared to manual patients at 3 months post-op. Key factors associated with achieving excellent clinical outcomes on the AKSS were: a pre-op activity level >5 on the UCLA activity score and use of robotic-arm assisted surgery.

Mako Partial Knee key clinical studies
Cost

Title

Revision analysis of robotic-arm assisted and manual unicompartmental knee arthroplastyJournalJ Arthroplasty

Year

2019

Author(s)

Cool CL, Needham KA, Khlopas A, Mont MA

Institution(s)

Baker Tilly, NY; Cleveland Clinic, OH; Lenox Hill Hospital, NY

Conclusion

This study demonstrated that patients who underwent Mako Partial Knee had fewer revision procedures, shorter length of stay, and incurred lower mean costs during the index admission and at 24 months post-op.

Mako Total Hip key clinical studies
Accuracy to plan

 

Title

Accuracy of component positioning in 1980 total hip arthroplasties: a comparative analysis by surgical technique and mode of guidance

Journal

The Journal of Arthroplasty

Year

2018

Author(s)

Domb B, Redmond J, Louis S, Alden K, Daley R, LaReau J, Petrakos A, Gui C, Suarez-Ahedo C

Insitution(s)

American Hip Institute

Conclusion

Robotic-guided surgery was more accurate to plan than other techniques and modes of guidance in placing the acetabular component within the Lewinnek and Callanan safe zones.

 

 

Title

Variance in predicted cup size by 2-dimensional vs 3-dimensional computerized tomography-based templating in primary total hip arthroplasty

Journal

Arthroplasty Today

Year

2017

Author(s)

Osmani F, Thakkar S, Ramme A, Elbuluk A, Wojack P, Vigdorchik JInsitution(s)NYU Langone Medical Center, Hospital for Joint Disease

Conclusion

CT-guided planning more accurately predicted hip implant cup size when compared to the significant overpredictions of digital and acetate templating. CT-guided templating may also lead to better outcomes due to bone stock preservation from a smaller and more accurate cup size predicted than that of digital and acetate predictions.

 

 

Title

Precision of acetabular cup placement in robotic integrated total hip arthroplasty

Journal

Hip International

Year

2015

Author(s)

Elson L, Dounchis J, Illgen R, Marchand R, Padgett D, Bragdon C, Malchua H

Institution(s)

Massachusetts General Hospital; Creekside Medical Center; South County Hospital; Hospital for Special Surgery

Conclusion

In this 120 patient, multi-center study, intraoperative robotic assistance allowed for precision of preparation and position of the acetabular cup to plan during total hip arthroplasty.

 

 

Title

Accuracy of cup positioning and achieving desired hip length and offset following robotic THA

Journal

Presented at CAOSYear2014

Author(s)

Jerabek S, Carroll K, Marratt J, Mayman D, Padgett D

Insitution(s)

Hospital for Special Surgery

Conclusion

In this cadaveric study of 21 robotic THAs, robotic THA provided excellent accuracy and precision with regard to planned cup position, hip length and offset.

 

 

Title

Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair control study

Journal

Clinical Orthopaedics and Related Research

Year

2013

Author(s)

Domb B, Bitar Y, Sadik A, Stake C, Botser I

Insitution(s)

American Hip Institute

Conclusion

Use of robotic system allowed for improvement in placement of the cup in both Lewinnek and Callanan safe zones.

Mako Total Hip key clinical studies
Bone preservation

 

Title

Robotic-arm assisted total hip arthroplasty results in smaller acetabular cup size in relation to the femoral head size: a matched-pair controlled study

Journal

Hip International

Year

2017

Author(s)

Suarez-Ahedo C, Gui C, Martin T, Chandrasekaran S, Lodhia P, Domb B

Insitustion(s)

American Hip Institute

Conclusion

Using acetabular cup size relative to femoral head size as an approximate surrogate measure of acetabular bone resection, these results may suggest greater preservation of bone stock using RTHA compared to CTHA.

Mako Total Hip key clinical studies
Outcomes

 

Title

Conventional vs robotic-arm assisted total hip arthroplasty (THA) surgical time, transfusion rates, length of stay, complications and learning curve

Journal

Journal of Arthritis

Year

2018

Author(s)

Heng Y, Gunaratne R, Ironside C, Taheri A

Institution(s)

Joondalup Health Campus, Australia; Curtin University, Australia

Conclusion

In this retrospective, singe-surgeon study, the observed reduction in LOS, comparable surgical times and potential for fewer complications may outweigh the increased initial cost associated with the robotic system.

 

 

Title

Robotic-assisted total hip arthroplasty: outcomes at minimum two-year follow-up

Journal

Surgical Technology International

Year

2017

Author(s)

Illgen R, Bukowski B, Abiola R, Anderson P, Chughtai M, Khlopas A, Mont M

Institution(s)

University of Wisconsin; Cleveland Clinic

Conclusion

RA-THA improved acetabular component accuracy and reduced dislocation rates compared with mTHA.

 

 

Title

Improved functional outcomes with robotic compared with manual total hip arthroplasty

Journal

Surgical Technology International

Year

2016

Author(s)

Bukowski B, Anderson P, Khlopas A, Chughtai M, Mont M, Illgen R

Institution(s)

University of Wisconsin; Cleveland Clinic

Conclusion

In a retrospective, cohort study, using a single-center database, the rTHR cohort demonstrated significantly higher mean postoperative UCLA scores, higher mean postoperative mHHS scores, and a greater percentage of patients with mHHS of 90 to 100 points compared with mTHA at a minimum one-year follow-up.

SMARTROBOTICS TODAY

MKOSYM-SS-7_Rev-1_23887

*For the Mako Total Knee application, “cut less” refers to less soft tissue damage and greater bone preservation as compared to manual surgery.8,9 For the Mako Total Hip and Partial Knee applications, “cut less” refers to greater bone preservation as compared to manual surgery.7,10

References:

  1. 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.
  2. 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.
  3. 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.
  4. Haddad, F.S., et al. 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. The Bone & Joint Journal, July 2018.
  5. Dretakis, K, Igoumenou, VG. Outcomes of robotic-arm assisted medial unicompartmental knee arthroplasty: minimum 3-year follow-up. European Journal of Orthopaedic Surgery & Traumatology. 2019 Aug;29(6):1305-1311.
  6. Nawabi D, Conditt M, Ranawat A, Dunbar N, Jones J, Banks S, Padgett D. Haptically guided robotic technology in total hip arthroplasty: A cadaveric investigation. Proc Inst Mech Eng H. 2013 Mar;227(3):302-9.
  7. Suarez-Ahedo, C; Gui, C; Martin, T; Chandrasekaran, S; Domb, B. Robotic arm assisted total hip arthoplasty 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.
  8. Haddad, F.S, et al. 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 Aug;33(8):2496-2501. Epub 2018 Mar 27.
  9. Hozack, W, Chen, A, Khlopas, A, Mahoney, O, Mont, M, Murray, T, Orozco, F, Higuera Rueda, C, Stearns, K. Multicenter Analysis of Outcomes after Robotic-Arm Assisted Total Knee Arthroplasty. American Academy of Orthopedic Surgeons Annual Meeting. Las Vegas, NV. March 12-16, 2019.
  10. Hampp E, Chang TC, Pearle A. Robotic partial knee arthroplasty demonstrated greater bone preservation compared to robotic total knee arthroplasty. Annual Orthopaedic Research Society. Austin, TX. 2-5 Feb 2019.
  11. Kayani B, Konan S, Tahmassebi J, Rowan FE, Haddad FS. An assessment of early functional rehabilitation and hospital discharge in conventional versus robotic-arm assisted unicompartmental knee arthroplasty. Bone Joint J. 2019 Jan;101-B(1):24-33.
  12. Suarez-Ahedo C, Gui C, Martin T, Chandrasekaran S, Lodhia P, Domb B. 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.
  13. Stryker’s sales and case data
  14. 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.
  15. 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? International Society for Technology in Arthroplasty 32nd Annual Congress. Toronto, Canada. October 2-5, 2019.