HSS Florida, 300 Palm Bch Lake Blvd, West Palm Bch, FL, 33401, USA.
Arch Orthop Trauma Surg. 2021 Dec;141(12):2043-2047. doi: 10.1007/s00402-021-04208-0. Epub 2021 Nov 10.
The Mako robotic arm knee arthroplasty system was initially indicated in unicompartmental knee arthroplasty followed by bicompartmental and total knee arthroplasty techniques. The system utilizes three elements: (1) Pre-op 3D CT based planning and image based intra-op navigation. (2) Pre-resection implant modifications with integrated alignment, implant position and gap data, and (3) A semi-constrained robotic arm assisted execution of bone resection with "haptic" boundaries, and cemented implants.
This paper evaluates variable pre-op implant placement, and anatomic reference positioning; data entry with incorporation of alignment, implant congruency through range of motion, and gaps; bone resection with "haptic" boundaries, and final implant evaluation with kinetic sensors.
The Mako system allowed for improved implant placement utilizing CT guidance, bone resection accuracy, flexibility for functional implant placement with gap balancing. When combined with kinetic sensors, there was improved rotation and soft tissue balance.
The MAKO robotic system can assist the surgeon with anatomic landmarks, provides the flexibility for independent gap balance through implant and alignment refinement, and three-dimensional soft tissue balancing data to achieve functional stability. Registry data has shown improved outcome survivorship irrespective of the surgeons' volumes and learning curves.
Mako 机械臂膝关节置换系统最初适用于单间室膝关节置换术，随后适用于双间室和全膝关节置换技术。该系统使用三个元素：（1）术前基于 3D CT 的规划和基于图像的术中导航。（2）预切除植入物的修改，包括集成的对准、植入物位置和间隙数据，以及（3）半约束机械臂辅助执行骨切除，具有“触觉”边界和粘结植入物。
本文评估了术前植入物位置和解剖参考位置的变化；数据输入，包括对准、通过运动范围的植入物一致性以及间隙；骨切除时具有“触觉”边界，以及使用动力学传感器进行最终植入物评估。
Mako 系统允许利用 CT 引导进行改进的植入物放置、骨切除的准确性、通过间隙平衡实现功能植入物放置的灵活性。当与动力学传感器结合使用时，旋转和软组织平衡得到改善。
Mako 机器人系统可以帮助外科医生使用解剖标志，通过植入物和对准的细化提供独立间隙平衡的灵活性，以及三维软组织平衡数据，以实现功能稳定性。注册数据表明，无论外科医生的手术量和学习曲线如何，都能提高手术效果的存活率。
