Information alert

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As part of the planning for your joint replacement surgery, you will have completed the pre-assessment process. You will have been given patient information telling you all about what to expect before, during and after surgery. 

This additional information is for patients who are having joint replacement surgery, using Mako Robotic-Arm Assisted Technology. 

It explains what Mako Robotic-Arm Assisted Technology is, and why your surgeon is using it for your joint replacement. 

The Mako Robotic-Arm has been in use at UCLH since 2017 but was exclusively for patients participating in clinical research. Since 2021, the Mako procedure has been available for all patients.

Mako Robotic-Arm Assisted Technology [Mako technology] is a combined system of computer software and a robotic-arm. It assists your surgeon in performing your joint replacement.  

It’s important to understand that the Mako Robotic-Arm doesn’t actually perform the surgery. Surgery is performed by your orthopaedic surgeon, who uses the Mako System software to pre-plan your surgery. Your orthopaedic surgeon will guide the Mako robotic-arm to remove diseased bone and cartilage. Then the surgeon will insert your joint replacement themselves in the usual manner. The robotic arm does not do this part of the operation.

The Mako technology provides your surgeon with a patient-specific three-dimensional model to pre-plan your joint replacement.  

This helps provide more accurate placement of your joint replacement, which is designed to improve the short and long-term outcomes of your surgery. 

These improvements in the short-term may include:  

  • less pain after the operation 
  • decreased time using crutches or a stick 
  • fewer days in hospital 
  • quicker return to normal function and / or work. 

In the long-term, these may include:  

  • improved movement of the joint 
  • the likelihood the joint replacement itself will last longer, so another operation due to the joint replacement wearing out would be much further into the future.

Robot-assisted surgery has some extra risks compared with non-robotic conventional hip and knee replacement surgery. The Mako technology surgery requires an additional planning CT scan, which is associated with extra radiation exposure. It may also require additional skin incisions for the insertion of pins to track bones around the joint during surgery. These pins leave holes in the bone after surgery which means a very small additional risk of the bone breaking or infection. It is important to speak directly with your Orthopaedic Surgeon if you have any questions about this.  

Please also refer to the booklet provided for you in pre-assessment, for all the risks associated with joint replacement surgery.

Your surgeon will have discussed with you the reasons why he or she wants to use Mako technology to assist with your joint replacement. 

If you do not want him or her to use Mako technology during your surgery, then he or she will perform the surgery without the assistance of the robotic-arm.

The alternative to Mako Robotic-Arm Assisted Technology is for the surgeon to perform the surgery without any robotic assistance.  

Both interventions - Mako technology and conventional surgery - are excellent treatments for end stage osteoarthritis in a hip or knee joint. It is suggested that the robotic arm may decrease hospital stay and increase return to normal function.

You will have already been through the pre-assessment process to help you prepare for your joint replacement surgery, and you should refer to the information booklet that was provided. 

Other than the planning CT scan, you do not have to do anything extra if you are having Mako technology with your joint replacement. Your preparation otherwise is identical to conventional surgeon-only joint replacement.

We want to involve you in all the decisions about your care and treatment. If you decide to go ahead with treatment, by law we must ask for your consent and will ask you to sign a consent form. This confirms that you agree to have the procedure and understand what it involves. Staff will explain all the risks, benefits and alternatives before they ask you to sign a consent form. If you are unsure about any aspect of your proposed treatment, please don’t hesitate to speak with a senior member of staff again. 

The Mako computer software uses images to create a unique, three-dimensional model of your joint. This is then used to create a personalised plan for your joint replacement procedure. 

During the operation, the surgeon will use the Mako technology to assist in performing the surgery based on your personalised pre-operative plan. 

The Mako System also allows the surgeon to make adjustments to the plan during surgery as needed. 

It is important to remember that the Mako robotic-arm does not perform the surgery. The surgeon performs the surgery, with assistance from the robotic-arm.

After surgery, your surgeon, nurses, physiotherapists and occupational therapists will set goals with you to get you back on the move. They will closely monitor your condition and progress. Follow up will be at the same time intervals as for patients undergoing conventional surgery without the Mako technology. Please refer to the pre-assessment information booklet for detailed information about what to expect after surgery.

After surgery, your surgeon, nurses, physiotherapists and occupational therapists will set goals with you to get you back on the move. They will closely monitor your condition and progress. Follow up will be at the same time intervals as for patients undergoing conventional surgery without the Mako technology. Please refer to the pre-assessment information booklet for detailed information about what to expect after surgery.

After surgery, your surgeon, nurses, physiotherapists and occupational therapists will set goals with you to get you back on the move. They will closely monitor your condition and progress. Follow up will be at the same time intervals as for patients undergoing conventional surgery without the Mako technology. Please refer to the pre-assessment information booklet for detailed information about what to expect after surgery.

Hospital Switchboard: 020 3456 7890 

Direct line: 07811 734 874 

Email: UCLH.Orthopaedics@nhs.net  

Address:

Trauma & Orthopaedics 

Department Surgical Specialties Division 

Ground Floor Central 

250 Euston Road 

London, NW1 2PG  

‘Having surgery at UCLH’ – a patient education film   

Stryker   

NHS Choices Website - Knee replacement

NHS Choices Website - Hip replacement  

National Joint Registry Website  

British Orthopaedic Association   

UCLH cannot accept responsibility for information provided by other organisations.

  • Dunbar NJ, Roche MW, Park BH et al. Accuracy of Dynamic Tactile- Guided Unicompartmental Knee Arthroplasty. Journal of Arthroplasty. May 2012. 27(5): 803-808.e1.  
  • Bell S, Anthony I, Jones B et al. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty. J Bone Joint Surg Am. 2016;98:627-635.  
  • https://www.boa.ac.uk/standards-guidance/guidance-documents/robotics-in-orthopaedics.html

On discharge you will be given contact details in case you have any questions regarding your post-operative recovery. 

To enquire about district nursing services please contact your general practitioners practice. 

To enquire about your consultant follow up appointment please contact the UCLH orthopaedic department on: 

07811 734 874 

UCLH.Orthopaedics@nhs.net  

To enquire about your imaging appointments please contact the Imaging department on: 

020 3456 7002 

uclh.referrals.imaging.booking.office@nhs.net  

To enquire or make a physiotherapy outpatient appointment please call the UCLH contact centre on: 

020 3447 9393 

uclh.mskth@nhs.net  

To contact the UCLH Therapy and Rehabilitation (physiotherapists and occupational therapists) team regarding therapy questions other than outpatient appointments contact: 

07890 636 584 

uclh.orthopaedic.therapies@nhs.net  

Both telephone messages and email in therapies are checked daily Monday to Friday. 

Website

University College London NHS Trust 

235 Euston Road 

London 

NW1 2BU 

020 3456 7890 

Website


Page last updated: 10 October 2024

Review due: 01 October 2026