Robotic Knee Arthroplasty with the MAKO System: What Is It?

Knee arthroplasty is a surgical procedure that replaces the damaged surfaces of the joint with highly durable implants that are compatible with the human body. The main types of knee arthroplasty are Total Knee Arthroplasty, in which the entire joint is replaced with an artificial one, and Partial (Unicompartmental) Arthroplasty, where only the diseased part of the knee is replaced while the healthy part remains completely intact.

Robotic surgery helps achieve an optimal outcome that is both preplanned and reproducible, using the most advanced technological methods. With the latest-generation MAKO robotic-assisted system at HYGEIA Hospital, Total and Partial Knee Arthroplasty procedures can be performed with great precision, minimal invasiveness, and results that closely resemble the natural knee. The MAKO technology, using a robotic arm, assists the surgeon in performing the arthroplasty with millimeter-level accuracy in tissue preparation and implant placement.

How is the preoperative planning done?

Before the surgery, a CT scan of the knee is performed to reproduce a 3D digital model of the patient’s unique anatomy. This virtual model is uploaded into the MAKO software and is used by the surgeon to develop a detailed, personalized, and three-dimensional preoperative plan.

What happens during robotic knee arthroplasty surgery?

During the surgery, the surgeon guides the robot-assisted arm according to the individualized digital plan created earlier.

In Partial Arthroplasty, this allows the surgeon to remove only the damaged cartilage and subchondral bone, preserving the healthy cartilage and cruciate ligaments of the knee.

During the procedure, the MAKO technology allows the surgeon to modify the preoperative plan as needed.

When the surgeon prepares the bone to receive the implant, the MAKO system guides them within the predefined area in all three dimensions and does not allow deviation outside the pre-planned boundaries. The accurate placement and alignment of the implants significantly enhance their longevity.

According to studies from the USA, the precision provided by the MAKO robotic system in preparing and placing the implants reaches approximately 99%, compared to 68% with traditional techniques.

What happens after robotic knee arthroplasty?

After the surgery, the patient is transferred to their room and knee mobilization begins immediately. In most cases, the patient can bear weight on the leg right away and walk with assistance in less than 24 hours. Hospital stay is typically one day for partial arthroplasty and between one to three days for total arthroplasty. For the first few days or weeks, the patient may need to use a pair of crutches until they feel confident to move around without them.

A physiotherapist will assist with mobilization and provide instructions for range-of-motion and strengthening exercises. The time required to return to daily activities varies from person to person and depends on the degree of joint wear, body weight, age, physical condition, and more.

According to studies, patients who have undergone knee arthroplasty may be able to drive again within four to six weeks.

What are the advantages of robotic knee arthroplasty?

• High precision (millimeter-level) in implant placement due to personalized 3D preoperative planning and robotic assistance during surgery
• Ability to assess ligament stability intraoperatively
• Less bone and soft tissue destruction
• Reduced blood loss
• Fewer complications and reduced need for revision surgery
• Less postoperative pain
• Shorter hospital stay
• Faster mobilization and recovery

Specifically for Partial Knee Arthroplasty:

• Natural joint feel due to preservation of cruciate ligaments
• Ability to treat osteoarthritis at an early stage
• Smaller incisions