While partial knee replacement accounts for less than 10% of all knee arthroplasty performed, studies have indicated the incidence could be 20% or more depending on timing of surgery with the disease process9. Over 1,000 Mako robotic-arm assisted partial knee procedures have been performed in Australia since introduction in 2015.
A 3D model of the patient’s anatomy is generated from a pre-operative CT Scan. This offers a virtual view of the entire joint from all angles. This virtual model is used to plan the initial implant size, orientation, and alignment to create a patient specific 3D preoperative surgical plan. The plan is reviewed and approved by the surgeon pre-operatively.
Intra-operatively surgeons make changes to the patient specific pre-operative plans to optimise the implant placement based on joint function. The ability to intra-operatively fine tune the planned implant placement accommodates hard and soft tissue anatomy for optimised implant articulation and ligament balancing.
In the Mako Partial Knee application surgeons passively correct the limb alignment and the Mako system collects data regarding how the implants are articulating through the patient’s range of motion. The distance between the pre-planning implants is shown on a graph and fine adjustments are made to balance the soft tissues before any bone resection is made. The alignment of the implants is shown and components can be adjusted to centre the femoral component on the tibial baseplate to avoid edge loading. Surgeons can also map the articular cartilage to determine the thickness and ensure a smooth transition from cartilage to implant.
Mako robotic-arm assistance allows for accurate and reproducible execution of the patient specific plan. Bone resection is controlled within a pre-defined resection volume and provides 3D visualisation of patient anatomy and real time resection progress. Power to the motor is only active when within the planned resection area. The system offers tactile, visual, and auditory feedback to the surgeon and will cut off power to the end effector if it is forced past the boundary.
A single 6mm burr is used to sculpt the bone to accurately fit the contours of the Mako MCK implants. Surgeons manually place the components once bone resection is complete and can verify that they have executed the patient specific plan.
The Mako MCK family of partial knee implants are specifically designed for Stryker’s Robotic-Arm Assisted Surgery procedures, which enable the treatment of one or two compartments of the osteoarthritic knee.
Mako MCK Multicompartmental Knee System offers an alternative solution for patients suffering osteoarthritis in one of more compartments of the knee – medial, patellofemoral, lateral or bicompartmental. As such, the Mako MCK System consists of a femoral, patellofemoral, and tibial component. This partial knee replacement system has been designed to offer several potential benefits to patients, including enhanced patient mobility and may result in quicker recoveries and shorter hospital stays4,5,6. All joints do wear over time and sometimes need to be replaced, but Mako has been designed for longevity7.
Each patient will experience a different post-operative activity level, depending on their own individual clinical factors.
The purpose of this multicentre study was to evaluate survivourship of an anatomically-designed UKA component implanted using a robotic-arm assisted surgical technique. Patients were recruited from a consecutive series for each surgeon starting with their initial MAKO MCK patient, thus including the surgeons learning curve.
Prospective, single centre, level I, blinded, randomised controlled trial between Mako Partial Knee and Biomet Oxford
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