Mako Technology in ASC settings:
two perspectives
Mako in the ASC Setting - the Saint Cloud Experience
Joseph Nessler, MDSartell, MN
At Saint Cloud Surgery Center, we started our outpatient hip and knee replacement program in late 2014. Startup was slow due to multiple factors: poor reimbursements, lack of contracting success with insurers, slow adoption by surgeons, and lack of differentiating technologies or techniques to garner patient interest.
That all changed by mid-2015. St. Cloud Surgery Center successfully negotiated bundled and fee for service contracts with most of the payers in our area. In addition, my practice group, which has always been technology driven, requested Mako Robotic-Arm Assisted Technology at both our local hospital and our ASC. After extensive review by my physician owned ASC and our corporate general partner, the purchase of our first Mako System was approved. Cases began May 2015, with both Mako Partial Knee and Total Hip applications. We later adopted Mako Total Knee, as soon as it became commercially available.
The introduction of Mako to our offering at the Saint Cloud Surgery Center was a point of differentiation. I believe that this, along with an extensive education and marketing program, contributed to patients requesting the Mako Technology. The surgeon partners in my practice group were impressed by several aspects of this technology, particularly, ease of adoption and positive outcomes6,9,10.
We at St. Cloud Surgery Center believe that Mako has had a positive impact on the Center's performance. Our practice has seen increasing patient demand and request for the Mako Technology. Coupled with technology education and marketing, along with surgeon enthusiasm for robotic-arm assisted procedures, St. Cloud's saw a year-over-year increase in total joint volume despite a year-over-year decrease in total joint volume at the hospital. The very next year, St. Cloud Hospital purchased a Mako System and believes it is a contributing factor to an upswing in volumes in both the inpatient and ASC locations. Our community now has four Mako systems: two in the St. Cloud Surgery Center and two in our hospital. The majority of all our total hips, knees, and partial knees are now performed with the Mako System.
Downloadable resources:
References:
- Bert JM, Hooper J, Moen S. Outpatient Total Joint Arthroplasty. Current Reviews in Musculoskeletal Medicine. 2017;10(4):567-574. doi:10.1007/s12178-017-9451-2.
- Jerabek SA, Carroll KM, Maratt JD, Mayman DJ, Padgett DE. Accuracy of cup positioning and achieving desired hip length and offset following robotic THA. 14th Annual CAOS Meeting 2014; Milan, Italy
- Domb BG, El Bitar YF, Sadik BS, Stake CE, Botser IB. Comparison of robotic assisted and conventional acetabular cup placement in THA: A matched-pair controlled study. Clin Orthop Relat Res 2014;472(1):329–36
- SW Bell, I Anthony, B Jones, A MacLean, P Rowe, M Blyth. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study. Journal of Bone and Joint Surgery, 2016.
- Hampp EL, Scholl LY, Prieto M, Chang TC, Abbasi A, Bhowmik-Stoker M, Otto JK, Jacofsky DJ, Mont MA. Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy to plan compared to manual technique. Orthopaedic Research Society 2017 Annual Meeting, San Diego, CA. Poster No. 2412. March 20-22, 2017.
- Kleeblad LJ, Coon TM, Borus TD, Pearle AD. Midterm Survivorship and Patient Satisfaction of Robotic-Arm Assisted Medial Unicompartmental Knee Arthroplasty: A Multicenter Study. The Journal of Arthroplasty, January 2018: 1-8.
- Marchand RC, Sodhi N, Khlopas A, Sultan AA, Harwin SF, Malkani AL, Mont MM. Patient satisfaction outcomes after robotic-arm assisted total knee arthroplasty: a short-term evaluation. J Knee Surg. 2017 Nov;30(9):849-853.
- Chen A, et al. Time-related learning curve of robotic-arm assisted total knee arthroplasty. AAOS Poster No. 5373. New Orleans, LA. 8 March 2018.
- Borus T; Roberts D; Fairchild P; Christopher J; Conditt M; Branch S; Matthews J;Pirtle K; Baer M. UKA patients return to function earlier than TKA patients. Bone &Joint Journal Orthopaedic Proceedings Supplement 2016;98(SUPP 1): 50-50.
- Zuiderbaan HA; Van der list JP; Khamaisy S; Nawabi DH; Thein R; Ishmael C; Paul S; Pearle AD. Unicompartmental knee arthroplasty versus total knee arthroplasty: Which type of artificial joint do patients forget? Knee Surg Sports Traumutol Arthrosc. Published online 21 Nov 2015.
Drs. Nessler and Martin are paid-consultants of Stryker. The opinions expressed by Drs. Nessler and Martin are their own and not necessarily those of Stryker. Individual surgeon and/or hospital site 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. 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 sales representative if you have questions about the availability of 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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