A couple of years ago, the thought of using a robot and related 3D software to aid in total knee arthroplasty (a surgical procedure pervasively used to treat severe osteoarthritis), may have seemed like something out of a science fiction novel. Well, not anymore!
Meet the MAKO Rio Robotic Arm! MAKO robotic-arm assisted surgery uses 3D imaging technology and miniaturized surgical instruments, placed throughout the area of operation, to resurface the knee for placement of the implants. This video gives a brief introduction to the MAKO robot while exploring evidence from literature related to its efficacy & feasibility for TKA.

This video was made by McMaster Demystifying Medicine students: Mansi Patel, Maiura Muralitharan, and Abdel-Rahman Mohamed-El Faki.

Copyright McMaster University 2020


References:
1. An Inside Look at Knee Replacement Surgery. (2019). WebMD. Retrieved October 17, 2020, from https://www.webmd.com/osteoarthritis/knee-replacement-18/video-knee- replacement-inside-look

2. Arthritis Alliance of Canada. (2011). The impact of arthritis in Canada: Today and over the next 30 years. Arthritis Alliance of Canada. Retrieved September 26, 2020, from https://www.arthritisalliance.ca/images/PDF/eng/Initiatives/20111022_2200_impact_of_a rthritis.pdf
3. Blyth MJG, Anthony I, Rowe P, et al. Robotic arm-assisted versus conventional unicompartmental knee arthroplasty: Exploratory secondary analysis of a randomised controlled trial. Bone Joint Res. 2017;6(11):631-639. doi:10.1302/2046-3758.611.BJR- 2017-0060.R1
4. Blyth, M., Anthony, I., Rowe, P., et al. (2017). Robotic arm-assisted versus conventional unicompartmental knee arthroplasty: Exploratory secondary analysis of a randomised controlled trial. Bone & joint research, 6(11), 631–639.
5. Carter, A. (2019, February 22). Knee replacement surgery performed with a robot for the first time in Canada. CBC. https://www.cbc.ca/news/canada/hamilton/robot-knee- replacement-1.5029788
6. Grau, L., Lingamfelter, M., Ponzio, D., et al. (2019). Robotic arm assisted total knee arthroplasty workflow optimization, operative times and learning curve. Arthroplasty today, 5(4), 465–470. https://doi.org/10.1016/j.artd.2019.04.007
7. Jones, D. (2018, December 4). First Mako Rio surgery robot comes to Hamilton, Ontario. St.Joseph’s Healthcare. https://www.stjoes.ca/our-stories/news/~1973-First-Mako-Rio- surgery-robot-comes-to-Ha milton-Ontario
8. Kalavrytinos, D., Koutserimpas, C., Kalavrytinos, I., et al. (2020). Expanding Robotic Arm-Assisted Knee Surgery: The First Attempt to Use the System for Knee Revision Arthroplasty. Case reports in orthopedics, 2020, 4806987. https://doi.org/10.1155/2020/4806987
9. Kayani, B., Konan, S., Pietrzak, J., et al. (2018). 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, 33(8), 2496–2501. https://doi.org/10.1016/j.arth.2018.03.042
10. MAKO Total Knee. (n.d.). Stryker. Retrieved September 26, 2020, from https://patients.stryker.com/knee-replacement/options/mako-robotic-arm-assisted-total- knee
11. Marchand, R. C., Sodhi, N., Khlopas, A., et al. (2017). Patient Satisfaction Outcomes after Robotic Arm-Assisted Total Knee Arthroplasty: A Short-Term Evaluation. The journal of knee surgery, 30(9), 849–853. https://doi.org/10.1055/s-0037-1607450
12. Netravali, N. A., Shen, F., Park, Y., et al. (2013). A perspective on robotic assistance for knee arthroplasty. Advances in orthopedics, 2013, 970703. https://doi.org/10.1155/2013/970703
13. Sousa, P. L., Sculco, P. K., Mayman, D. J., et al. (2020). Robots in the Operating Room During Hip and Knee Arthroplasty. Current reviews in musculoskeletal medicine, 13(3), 309–317. https://doi.org/10.1007/s12178-020-09625-z

Credits: The MAKO system robot animations were adapted from the Stryker website.
The TKA animation was adapted from WebMD.