How Mako® Total Hip has changed my standard of care
Message from Russ Cohen, MD
Tucson Orthopaedics Institute, Tucson, AZ
For many years, performing hip replacement was very gratifying and provided mostly positive feedback from my patients. Pain relief was excellent1, time away from "life" while recovering was mostly tolerable2 and the satisfaction level quite good3. However, there were a group of patients for whom the outcome was not always as good and left them relying on burdensome restrictions, or the "excuse" that we had to make the leg longer to achieve the desired result of not dislocating4. Until I was introduced to Mako Total Hip a little over two years ago, this was the accepted standard in my practice. I was eager to find a way to reduce cup mal-positioning that has the potential to lead to complications and to be able to customize a plan and execute that plan for each patient.
Mako Technology has transformed my joint replacement surgeries. I have seen that pre-op planning is more accurate and beneficial in executing accurate placement of the cup5. You can customize cup position based on pre-op knowledge of native femoral version, and intraoperative information regarding leg lengths and offset6. With the help of haptic guidance, the ability to single stage ream allows for OR efficiencies and has demonstrated greater bone preservation, which has allowed me to use on average smaller cups than with manual preparation7. I have had the opportunity to implant the additive manufactured Trident II Tritanium acetabular shell for a little over two years. The implant features and the “bone-friendly” feel of the Tritanium surface make this shell a great option to use with Mako. For me, the accurate and consistent bone preparation to plan with Mako Total Hip8, coupled with a shell that I can reproducibly seat, makes for a less cumbersome acetabular experience.
I am truly a believer that Mako Total Hip has taken a great operation and made it even greater. For those who feel their hips "do well" and there is no need for this platform, I strongly encourage you to take a moment and see the Mako System in action. The learning curve for me was short and results speak volumes in the quest to enhanced accuracy and precision in component positioning that can make an impact on the patients and the surgeons. In my opinion, the technology has been transformative!
Watch My experience with Mako
Resources:
References:
- Bachmeier CJ, March LM, Cross MJ, et al. A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage 2001;9:137–46.
- Cowie J. G., Turnball G. S., Ke A. M., Breusch S. J.. Return to work and sports after total hip replacement. Arch Orthop Trauma Surg (2013) 133:695-700.
- Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780‐ 785.
- Desai A., Dramis A., Board T. Leg length discrepancy after total hip arthoplasty: a review of literature. Curr Rev Musculoskelet Med (2013) 6:336-341.
- Elson L, Dounchis J, Illgen R, Marchand R, et al. Precision of acetabular cup placement in robotic integrated total hip arthoplasty. Hip Int 2015; 25(6):531-536.
- Nawabi DH; Conditt MA; Ranawat AS; Dunbar NJ; Jones, J; Banks S, Padgett DE. Haptically guided robotic technology in total hip arthroplasty – A cadaveric investigation. Journal of Engineering in Medicine. December 2012;227(3):302-309.
- Suarez-Ahedo, C; Gui, C; Martin, T; Stake, C; Chandrasekaran, S; Christopher, J; Domb, B. Robotic-arm assisted total hip arthoplasty results in smaller acetabular cup size in relation to the femoral head size: A Matched-Pair Controlled Study. Hip Int. 2017; 27 (2): 147-152.
- Nawabi, D, Conditt, M, Ranawat, A, Dunbar, N, Jones, J, Banks, S, and Padgett, D. Haptically guided robotic technology in total hip arthroplasty - a cadaveric investigation. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering Medicine. Published online 6 December 2012. DOI: 10.1177/0954411912468540.
Dr. Cohen is a paid-consultant of Stryker. The opinions expressed by Dr. Cohen are those of Dr. Cohen and not necessarily those of Stryker. Individual experiences may vary.
A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery.
The information presented is intended to demonstrate the breadth of Stryker’s product offerings. A surgeon must always refer to the package insert, product label and/or instructions for use before using any of Stryker’s products. The products depicted are CE marked according to the Medical Device Directive 93/42/EEC. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets. Please contact your Stryker representative if you have questions about the availability of any of Stryker’s products in your area.
Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Mako, Stryker. All other trademarks are trademarks of their respective owners or holders.
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