Focus of the Report: This health technology assessment focuses on partial knee arthroplasty (PKA) with the Mako Robotic-Arm Assisted Surgery system for treatment of knee osteoarthritis (KOA).
Technology Description: The Mako Robotic-Arm system is a semi-active tactile robotic system, meaning that the robotic arm is under direct control of the surgeon who receives real-time tactile feedback during PKA. The Mako Robotic-Arm system also provides information on limb alignment and soft tissue balance so that the surgeon can properly align the Mako prosthetic implant and select the appropriate polyethylene insert. Robot-assisted PKA is designed to facilitate knee replacement surgery by allowing more precise implantation of the insert. Theoretical advantages of robot-assisted PKA over standard manual PKA include better alignment, preservation of healthy tissue and bone, better range of motion (ROM), improved gait, and higher patient satisfaction.
Controversy: PKA is technically challenging, and demands precise implant alignment and soft tissue balance for optimal knee function. Failure of manual PKA is predominantly caused by surgical error. Mako Robotic-Arm Assisted PKA uses computer surgical planning and navigation to enable more precise implantation of prosthetic implants. However, robotic systems are costly, and it is unknown whether there is a clinically significant benefit of using robotic-assisted PKA over conventional manual PKA.
Key Questions:
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Is PKA with the Mako Robotic-Arm Assisted Surgery system effective for treating osteoarthritis (OA) of the knee?
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How does PKA with the Mako Robotic-Arm Assisted Surgery system compare with conventional manual PKA or total knee arthroplasty (TKA) for OA of the knee?
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Is PKA with the Mako Robotic-Arm Assisted Surgery system safe?
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Have definitive patient selection criteria been identified for treatment of KOA with the Mako Robotic-Arm Assisted Surgery system?
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