Does the Type of Robot Matter in Knee Replacement?
Patients considering robotic-assisted knee replacement often encounter several different names, including Mako, VELYS, ROSA, and CORI. This naturally raises an important question: Does one robotic system produce a better knee replacement than another?
The answer is more nuanced than choosing one brand over another.
Different robotic systems use different methods to plan and perform knee replacement surgery. However, the technology does not independently determine the result. The surgeon must still evaluate the patient’s anatomy, assess ligament balance, select the implant position, perform the operation, and guide the recovery process.
What Does a Knee Replacement Robot Actually Do?
Robotic-assisted knee replacement does not mean that a robot performs the surgery on its own.
The system provides the surgeon with detailed information about the knee and helps carry out a patient-specific surgical plan. Depending on the platform, this may include:
Creating a three-dimensional model of the knee
Measuring leg alignment and joint movement
Assessing ligament tension and soft-tissue balance
Planning the position of the knee implants
Helping the surgeon make precise bone cuts
Confirming the final alignment and balance of the reconstructed knee
The surgeon remains in control throughout the procedure.
How Are Mako and VELYS Different?
Mako and VELYS are two commonly used robotic-assisted knee replacement systems. Both are designed to improve surgical planning and accuracy, but they accomplish this in different ways.
Mako Robotic-Arm Assisted Surgery
The Mako system generally uses a CT scan obtained before surgery to create a three-dimensional model of the patient’s knee.
The surgeon uses this model to develop a preoperative plan for implant positioning and alignment. During surgery, a robotic arm helps prepare the bone while limiting the cutting instrument to the boundaries of the surgical plan.
VELYS Robotic-Assisted Knee Replacement
The VELYS system does not typically require a preoperative CT scan.
Instead, information about the patient’s anatomy, alignment, and ligament balance is collected during surgery. The surgeon can then adjust the implant plan in real time based on how the individual knee moves and balances.
A robotic-assisted saw helps carry out the planned bone preparation while the surgeon maintains control of the procedure.
Is One Robotic System Better?
Current research does not clearly show that one robotic knee replacement platform produces the best results for every patient.
Most robotic systems are designed to improve the accuracy of implant positioning and reduce the number of cases that fall outside the surgeon’s intended alignment plan. However, precise bone cuts are only one part of a successful knee replacement.
Other important factors include:
Selecting the appropriate procedure
Restoring appropriate leg alignment
Balancing the knee’s ligaments
Positioning the implants for the individual patient
Preventing complications
Managing pain and swelling
Following a structured rehabilitation plan
Robotic technology is a surgical tool. How the surgeon interprets and uses the information provided by that tool remains critically important.
Different Systems, Similar Goals
Although robotic knee replacement systems use different imaging, planning, and bone-preparation methods, they share many of the same goals:
Creating an individualized surgical plan
Improving the accuracy of bone preparation
Measuring alignment during surgery
Evaluating ligament and soft-tissue balance
Helping the surgeon carry out the intended implant plan
A surgeon may use different robotic platforms at different hospitals or surgery centers. The specific system available may depend on the facility, implant contracts, and equipment arrangements.
For patients, the more meaningful question is not necessarily which brand of robot is being used. It is how the surgeon uses the available technology to plan the operation, balance the knee, position the implants, and confirm the final result.
Does Robotic Surgery Guarantee a Better Result?
No technology can guarantee a painless knee, a faster recovery, or a specific outcome.
Robotic assistance may improve surgical precision and help the surgeon consistently carry out the intended plan. It does not eliminate the normal healing process or the risks associated with knee replacement surgery.
Recovery still depends on several factors, including:
The severity of arthritis
Preoperative strength and range of motion
Overall health
Pain and swelling after surgery
Participation in rehabilitation
Individual healing
The robot can assist with surgical planning and execution, but it cannot control every factor that affects recovery.
What Should Patients Ask Their Surgeon?
Rather than choosing a surgeon based solely on the name of a robotic platform, patients may benefit from asking:
How frequently do you perform knee replacement surgery?
How do you determine implant alignment and ligament balance?
How does the robotic system affect your surgical plan?
Do you perform both total and partial knee replacement?
What is your typical recovery program?
What outcomes and complications does your practice track?
A surgeon should be able to explain not only which technology is used, but also how it contributes to the overall surgical strategy.
The Bottom Line
Mako, VELYS, and other robotic systems use different approaches to assist with knee replacement surgery. Current evidence does not establish that one platform consistently produces better results for every patient.
The name of the robot is only one part of the procedure. Patient selection, surgical planning, implant positioning, ligament balance, complication prevention, rehabilitation, and surgeon experience all contribute to the final result.
Patients should focus less on choosing a particular robotic brand and more on understanding how their surgeon uses the available technology to create and carry out an individualized surgical plan.
Patients in Johnson City and the surrounding East Tennessee region can learn more by visiting the Robotic-Assisted Total Knee Replacement page or by requesting an appointment.
