intraoperative map-
ping. Regardless of
the system, the
robotic arm acts as
a "well-informed
governor."
"The arm does
nothing by itself,"
he says. "It doesn't
do anything but
keep the tip of the
bur in the range of its preset limits. If I faint while I'm holding the bur
and it slams toward an area it shouldn't, it turns off. In addition, every-
thing is on the screen, so I see the area that needs to be milled out. An
additional benefit is that it can tell me how much extension there is
and how tight or loose the joint is, so it's more precise information. It
requires a lot less feel or guesswork."
What about outcomes between UKAs performed using a robotic-arm
assisted system and those that were performed manually? According
to a Stryker-backed study prepared by Baker Lily, just 1 (0.4%) of 284
robotic-assisted UKAs required revision surgery, whereas 46 (3.5%) of
the 1,312 UKAs performed non-robotically required revision.
Robotic-assisted systems do, however, have some roadblocks to
adoption. Chief among them is cost. Dr. Antkowiak suggests surgical
facilities might pay anywhere from $300,000 to nearly $1 million,
depending on the system. Also, the reimbursement is the same.
"It's about being able to add value, and that's a challenge," he says.
"But we have found that because of the advantages it offers, there's a
sophisticated patient population that's expecting the greatest technol-
ogy and biggest precision, so the system will pay itself off."
Another common criticism is that they may increase set-up time and
M a y 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 6 9
• PRECISION Stryker's Mako uses a pre-op CT scan to do the modeling for unicompart-
mental knee arthroplasties.
