Why you should consider robotic-arm assisted surgery for joint replacements

Why you should consider robotic-arm assisted surgery for joint replacements

Hip and knee replacements are in large demand as patients strive to remain active well into their senior years. For those in need of joint replacement, I encourage them to consider MAKO robotic-arm assisted surgery. When patients first hear this, they think: a robot is performing the surgery! Don’t worry – that is not the case. The robotic-arm serves as a tool for the surgeon, allowing him or her to perform with more precision than ever before.

What is MAKO robotic-arm assisted joint replacement surgery?

The MAKO robotic system allows us to customize the joint replacement experience for each individual patient with amazing accuracy and precision.  We can now truly make the implant fit the patient’s anatomy instead of altering the anatomy to fit the implant.

To figure out the exact positioning and orientation of the implants, our surgeons will use the robotic system’s tools to determine:

  • What thickness of bone to remove
  • Where to make bony cuts
  • How to help properly tension the soft tissues

Recent studies have demonstrated appropriate alignment, rotational position and soft-tissue balancing are critical in determining the long-term survival of hip and knee implants. Robotic-assisted joint replacement has drastically changed the outcomes for our joint replacement patients. After surgery, the overall alignment and soft tissue tension nearly conform to fit the area, which allows our patients to mobilize sooner and get back to their daily routines earlier.  We have also noticed less pain and less blood loss likely due to less soft tissue dissection when using the MAKO system for hip and knee replacement.

How does MAKO Work?

Before surgery, a CT scan of the involved joint is uploaded to the computer. During surgery, the surgeon collects data points from the operative hip or knee joint that are then sent to the computer.  Next the computer generates a custom patient-specific three-dimensional model from the CT scan and data points.  While viewing the computerized model, the surgeon then selects the implants that best fit the patient’s anatomy and precisely positions them to restore leg alignment and soft tissue tension.  It takes only 1-2 minutes to devise the plan.  Afterwards the robotic arm is brought into the operative field to carefully perform the bone cuts under the surgeon’s control.  The implants are then placed, the joint is checked for stability, and the incision is closed.

MAKO vs. Conventional Knee Replacement

In theory, a properly aligned joint replacement should, like your new car tires, last longer if well-balanced and in acceptable alignment.  For knee replacement, conventional cutting jigs can be, on average, up to 3 degrees and several millimeters off target leading to subpar implant alignment (view video). MAKO allows us to be more precise and accurate within 1 degree and 1-2 millimeters of anatomic alignment.  This can have drastic effects on the lifespan of the knee replacement.  One Australian study found that robotic-assisted surgery could decrease the risk of revision surgery by 13%.

MAKO is Unique

Currently, MAKO is the ONLY robot that can be used for hip replacement surgery (view video).  We can now reconstruct the hip joint to its pre-arthritic form by restoring leg length differences and re-establishing soft tissue tension, both of which significantly lower the risk of dislocation.  A MAKO total hip replacement can be performed through any approach including the minimally invasive direct anterior approach.


To schedule an appointment with one of our MAKO-certified joint replacement surgeons, please call Marshall Orthopaedics at 304-691-1262.  For more information about the MAKO robot, visit www.marshallhealth.org/MAKO


Matthew W. Bullock, DO, MPT

Dr. Bullock is a board-certified, fellowship-trained hip and knee surgeon specializing in primary and revision replacement. He is an assistant professor at Marshall University Joan C. Edwards School of Medicine.