AAOS News: Stryker Presents Improved Early Functional Recovery with Mako Total Knee

Stryker’s Joint Replacement Division announced the showcase of Mako Robotic-Arm Assisted Surgery data at the 2019 Academy Meeting. This includes a look at clinical studies examining early Mako Robotic-Arm Assisted Total Knee Surgery outcomes and patient benefits^1,2, as well as an analysis of Medicare claims data demonstrating lower episode of care costs to Medicare with the use of Mako Robotic-Arm Assisted Total Knee Surgery compared to manual total knee surgery³.
 
A prospective, consecutive series, single-surgeon study compared 40 patients undergoing manual total knee arthroplasty (TKA) to 40 patients undergoing Mako Robotic-Arm Assisted TKA. This study concluded that Mako Robotic-Arm Assisted TKA was associated with less post-operative pain, a decreased need for opiate analgesics, less time to hospital discharge with a 26 percent reduction in length of hospital stay and less need for in-patient physical therapy¹.
 
Additionally, a longitudinal, retrospective analysis of CMS Medicare claims data evaluated the 90-day episode-of-care (EOC) costs for manual TKA vs Mako TKA. This analysis concluded that Mako TKA patients had overall lower average 90-day EOC costs to Medicare compared to manual TKA, with costs savings driven by reduced facility costs, shorter lengths of stay, decreased readmissions and economically beneficial discharge destinations³.
 
“Mako has been changing the game across the entire joint replacement service line for years and we’re excited to continue leading the charge in this space,” said Stuart Simpson, president of Stryker’s Joint Replacement Division. “Mako is transforming the way hip and knee replacements are performed and we are proud to be at the forefront of the robotics movement in orthopedics.”
 
Mako utilizes a CT-based 3D modeling of bone anatomy to create a surgical plan that is personalized to the patient. The only robotic-arm assisted surgical technology equipped with haptic guidance, Mako has demonstrated in a cadaveric study more accurate bone resection to plan compared to manual instrumentation, enabling surgeons to limit soft tissue damage by providing visual, auditory, and tactile feedback limiting sawblade action outside of the haptic boundary⁴. Another prospective cohort study was performed to compare macroscopic bone and soft tissue injury between Mako TKA and manual TKA. The study included 30 consecutive manual TKAs followed by 30 consecutive Mako TKA procedures, all performed by a single surgeon. The results indicated reduced bone and soft tissue damage in the Mako patient group².
 
Stryker will showcase this data at the Academy meeting in Las Vegas, Nev. (booth #443) from March 12-16, 2019.
 
References
¹ Kayani, B., Konan, S., Tahmassebi, J., Pietrzak, J.R.T., Haddad, F.S. Robotic arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: A prospective cohort study. Bone and Joint Journal: 2018;100-B:930–7.
² Kayani, B., Konan, S., Pietrzak, J.R.T., Haddad, F.S. Iatrogenic Bone and Soft Tissue Trauma in Robotic-Arm Assisted Total Knee Arthroplasty Compared with Conventional Jig-Based Total Knee Arthroplasty: A Prospective Cohort Study and Validation of a New Classification System. The Journal of Arthroplasty: 2018;1-6.
³ Cool, C.L., Needham, K., Mont, M.A., Jacofsky, D.J. A 90 day episode of care cost analysis of robotic-assisted total knee arthroplasty. The Knee Society Meeting. New York, NY. September 20-22, 2018. While the coding of the Medicare claims data does not contain a specific Mako identifier, the robotic-arm assisted claims assessed for this analysis were Mako Total Knee procedures because such claims were classified as (1) utilizing a pre-operative CT scan within 60 days of the procedure and (2) a robotic-arm assisted procedure code was also utilized. Hospitals included in the analysis were also reviewed against a list of Mako system locations as an added verification step.
⁴ Khlopas, A., Chughtai, M., Hampp, EL., Scholl, LYt., Prieto, M, Chang, TC., et al. Robotic-arm assisted total knee arthroplasty demonstrated soft tissue protection. Surg Technol Int 2017;30:441-6.