Mako Robotic-Arm Assisted Knee Replacement Surgery

What is Mako Robotic Knee Replacement?

Mako Robotic Knee Replacement is an advanced surgical technique used to treat severe knee joint damage and pain, most commonly caused by osteoarthritis. It is a form of robotic-assisted Total Knee Replacement that allows highly accurate planning and execution of surgery using a 3D model of the patient’s knee.

This technology is used for:

• Total Knee Replacement – replacement of the entire knee joint
• Partial Knee Replacement – replacement of only the damaged portion of the knee
• Unicondylar Knee Replacement – replacement of one affected compartment (condyle) of the knee
• Unicompartmental Knee Replacement – resurfacing of a single damaged compartment while preserving healthy structures

The system assists Dr van Niekerk in achieving precise implant alignment and positioning, which may improve function, reduce soft tissue disruption, and support faster recovery.

Mako robotic-arm assisted surgery (knee replacement surgery) is a less invasive procedure that relies on a robust robotic arm to perform the procedure. This innovative system uses a three-dimensional knee model to ensure unparalleled precision during the procedure. The high level of accuracy provided by the Mako system allows the surgeon to create precise incisions for the knee implant, giving patients a sense of reassurance about the accuracy of the procedure.

Under the guidance of Dr van Niekerk, this advanced software allows for meticulous pre-planning of knee replacement surgery. The Mako system has been shown to lead to optimal surgical outcomes, significantly reduced pain, and a shorter recovery duration compared to traditional surgery. This means patients can look forward to a more comfortable and quicker recovery, instilling a sense of hope and optimism.

In a majority of clinical studies, the Mako total knee allowed surgeons to execute their surgical plans with precision, safeguard the ligaments and soft tissue from further damage and enable improved patient satisfaction.

What are the indications for robotic total knee replacement?

• Osteoarthritis of the knee - Osteoarthritis is a progressive condition where the protective cartilage in the knee wears away, causing bone-on-bone friction, pain, swelling, and reduced mobility.
• Advanced degenerative joint disease
• Chronic knee pain and stiffness
• Loss of cartilage in the knee joint
• Difficulty walking, climbing stairs, or performing daily activities
• Failure of non-surgical treatments such as physiotherapy, medication, or injections
• Localised knee damage suitable for partial (unicondylar or unicompartmental) replacement

How do you perform Mako robotic-arm-assisted knee replacement surgery?

A robotic total knee replacement is carried out very similarly to a traditional knee replacement surgery, except it's performed with the assistance of a hand-held robotic system.

It's important to note that the robotic system does not perform the procedure alone. Instead, it assists the surgeon, who is in control throughout the operation. The procedure is carried out under general anaesthetic, and an incision is made over the knee. The supportive structures of the knee are gently shifted, and the damaged cartilage and bone from the femur and tibia are removed. The robotic arm, guided by three-dimensional visuals from the CT scan, performs a range of tasks, such as preparing the bone, balancing the prosthetic device, and ensuring the right fit. The system, with the help of optical trackers and a camera, which is safely secured to the patient's leg, helps place the implant accurately during the procedure.

Active robotic sensors map the exact location of the knee replacement and assist with highly precise independent resection. As a result, the surgeon can accurately place the prosthetic using the system as a guide. Once the muscles are returned to their position, the incision is sealed, and the operative area is protected with a surgical dressing.

What is recovery like after robotic total knee replacement?

Recovery focuses on reducing pain, restoring movement, and rebuilding strength.

After surgery, patients can expect:

• Pain relief medication to manage discomfort
• Early gentle movement of the knee
• Physiotherapy to restore strength, balance, and flexibility
• Temporary use of crutches or a walking aid
• Wound care instructions to support proper healing

Most patients notice gradual improvement in mobility within weeks, with continued recovery over several months depending on individual progress.

What are the benefits of robotic knee replacement?

• Highly accurate implant positioning
• Improved joint alignment
• Reduced soft tissue disruption
• Potential for less postoperative pain
• Smaller and more precise bone cuts
• Faster rehabilitation in many patients
• Improved joint stability and function
• Better long-term implant performance outcomes

This procedure is performed at Cintocare Private Hopital in Pretoria, South Africa.