Mako Technology in ASC settings: 

two perspectives  

Mako in the ASC Setting - the Saint Cloud Experience

Joseph Nessler, MD
Sartell, MN

At Saint Cloud Surgery Center, we started our outpatient hip and knee replacement program in late 2014. Startup was slow due to multiple factors: poor reimbursements, lack of contracting success with insurers, slow adoption by surgeons, and lack of differentiating technologies or techniques to garner patient interest.  

That all changed by mid-2015. St. Cloud Surgery Center successfully negotiated bundled and fee for service contracts with most of the payers in our area. In addition, my practice group, which has always been technology driven, requested Mako Robotic-Arm Assisted Technology at both our local hospital and our ASC. After extensive review by my physician owned ASC and our corporate general partner, the purchase of our first Mako System was approved. Cases began May 2015, with both Mako Partial Knee and Total Hip applications. We later adopted Mako Total Knee, as soon as it became commercially available.

The introduction of Mako to our offering at the Saint Cloud Surgery Center was a point of differentiation. I believe that this, along with an extensive education and marketing program, contributed to patients requesting the Mako Technology. The surgeon partners in my practice group were impressed by several aspects of this technology, particularly, ease of adoption and positive outcomes6,9,10.

We at St. Cloud Surgery Center believe that Mako has had a positive impact on the Center's performance. Our practice has seen increasing patient demand and request for the Mako Technology. Coupled with technology education and marketing, along with surgeon enthusiasm for robotic-arm assisted procedures, St. Cloud's saw a year-over-year increase in total joint volume despite a year-over-year decrease in total joint volume at the hospital. The very next year, St. Cloud Hospital purchased a Mako System and believes it is a contributing factor to an upswing in volumes in both the inpatient and ASC locations. Our community now has four Mako systems: two in the St. Cloud Surgery Center and two in our hospital. The majority of all our total hips, knees, and partial knees are now performed with the Mako System.

Downloadable resources:

For the latest Mako Clinical Summary: Mako Partial Knee, Total Hip and Total Knee

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  8. Chen A, et al. Time-related learning curve of robotic-arm assisted total knee arthroplasty. AAOS Poster No. 5373. New Orleans, LA. 8 March 2018.
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  10. Zuiderbaan HA; Van der list JP; Khamaisy S; Nawabi DH; Thein R; Ishmael C; Paul S; Pearle AD. Unicompartmental knee arthroplasty versus total knee arthroplasty: Which type of artificial joint do patients forget? Knee Surg Sports Traumutol Arthrosc. Published online 21 Nov 2015.