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Robotic Knee Arthroplasty (Mako)

Robotic-arm assisted total and unicompartmental knee arthroplasty using the Mako Surgical System (Stryker) with preoperative CT-based planning, real-time intraoperative bone preparation guidance, and haptic feedback for precise component positioning and ligament balancing.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ortopedi ve Travmatoloji department. Book Appointment →

What is Robotic Knee Arthroplasty (Mako)?

Robotic knee arthroplasty with the Mako Surgical System (Stryker) represents an advanced surgical technology combining preoperative CT-based 3D planning with intraoperative robotic-arm haptic feedback for precise bone preparation. The Mako system was approved for unicompartmental knee arthroplasty (UKA) in 2006, total knee arthroplasty (TKA) in 2015, and total hip arthroplasty (THA) in 2010, transforming joint replacement surgery through enhanced precision and personalized planning.

Workflow includes preoperative planning where patient-specific CT scan generates 3D anatomical model allowing virtual implant sizing and positioning, intraoperative bone registration with Mako's optical tracking system aligning patient anatomy with virtual model, robotic-arm assisted bone preparation with haptic boundaries preventing deviation from plan, and dynamic soft tissue balancing assessment with real-time gap measurements throughout range of motion.

Clinical evidence shows Mako TKA achieves superior component alignment (within 1 mm/1 degree of plan in >90%), improved soft tissue balancing, reduced bone resection variability, and potentially less postoperative pain compared to manual technique. Long-term outcomes including survivorship and functional scores show comparable or modestly improved results, with ongoing studies of patient-specific kinematic alignment philosophy. Mako UKA shows excellent survivorship (>95% at 5 years) with improved component positioning.

Symptoms

Severe knee osteoarthritis with persistent pain despite conservative therapy
Bone-on-bone joint changes on weight-bearing radiographs
Functional limitations affecting walking, stairs, daily activities
Failed conservative treatment: physical therapy, NSAIDs, intra-articular injections, weight loss
Tricompartmental osteoarthritis (TKA candidate) or isolated medial/lateral OA (UKA candidate)
Inflammatory arthritis: rheumatoid arthritis, post-traumatic arthritis
Avascular necrosis with collapse

Risk Factors

Age >50 years (peak indication 60-80)
Female sex (slight female predominance)
Obesity (BMI >30) — increased OA risk and surgical complications
Prior knee injury or surgery (post-traumatic OA)
Occupational stress: heavy labor, repetitive squatting, kneeling
Family history of osteoarthritis
Inflammatory arthritis (rheumatoid, psoriatic) for advanced joint destruction

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Severe knee pain limiting daily activities and quality of life
  • Failed conservative therapy after 6+ months
  • Knee deformity (varus, valgus) with progressive functional decline
  • Bone-on-bone changes on radiographs with persistent symptoms
  • Considering knee replacement for surgical evaluation
  • Interest in robotic knee arthroplasty for precision and personalization
  • Recurrent infections or complications from previous knee surgery

Treatment Methods

01
Comprehensive evaluation: clinical examination, weight-bearing radiographs, knee alignment assessment, ligament stability testing
02
Conservative therapy trial: weight loss, physical therapy, NSAIDs, intra-articular corticosteroid or hyaluronic acid injections
03
Preoperative planning: CT scan for Mako 3D model, surgeon planning of implant size, position, alignment philosophy (mechanical vs kinematic)
04
Surgical procedure: robotic-arm assisted bone preparation with haptic boundaries, real-time soft tissue balancing, personalized implant positioning
05
Modern implants: cementless or cemented, cobalt-chromium or oxidized zirconium, polyethylene tibial insert with antioxidants
06
Multimodal pain management: regional anesthesia (adductor canal block), preoperative analgesia, opioid-sparing protocols
07
Rehabilitation: early mobilization, physical therapy, range of motion exercises, return to activities at 3-6 months, long-term follow-up with periodic radiographs

Which Department to Visit?

You can visit our Ortopedi ve Travmatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ortopedi ve Travmatoloji Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.