Makoplasty Anterior Hip Replacement

Makoplasty anterior hip replacement is a surgery to replace the diseased parts of the Hip joint with prosthetic parts. The aim is to duplicate the function and balance the muscular forces acting around the joint.

Traditionally, the surgery has been performed from behind known as the posterior approach or from the side known as the lateral approach. 

The more recent approach from the front, known as the anterior approach, promises a faster recovery with a decreased hospital stay.

The surgical technique, however, requires accurate placement and positioning of the implant. MAKOplasty is a unique robotic assistance system powered by RIO (Robotic Arm Interactive Orthopedic System), providing real time information. This helps in achieving precision in anterior Hip replacement. 

Hip pain or stiffness may be caused by conditions such as osteoarthritis, post-traumatic arthritis, inflammatory arthritis, or hip dysplasia. Hip pain which is not relieved by conservative management can benefit from Hip replacement surgery. 

The surgery involves access to the Hip joint and removal of diseased/arthritic bone. A prosthetic acetabular cup is placed in the pelvis socket with a specialized plastic over it to reduce friction. The upper part of the thigh is replaced with a prosthetic stem. A prosthetic head is placed over the stem.

Robotic hip replacement

X-ray showing robotic total hip replacement

Considerations for a successful surgery

Patient needs, skill, and expertise of the operating surgeon are important factors for successful outcomes of any surgery. Hip replacement surgery techniques such as MAKOplasty offer additional benefits for accurate implant placement. Accurate placement leads to an excellent outcome and an expedited recovery. 

Placement and alignment of Components

The biomechanics of the Hip joint warrant accurate positioning of the implant for the prosthetic joint to duplicate both mobility and stability of the natural joint. Every patient has slightly different anatomy of the hip joint requiring a different positioning of the complements. Inaccurate placement leads to impingement, dislocation, reduced lifespan of implant, leg length discrepancies, or failure. 


Bone preservation

Hip joint replacement requires the removal of diseased bone to make a place for the prosthetic implant. Removal of more than required bone leads to loss of bone stock for subsequent surgery and reduced stability for components. 


The anterior approach to the Hip joint involves an incision in front of the Hip joint. The approach allows for muscles and tendons to be separated instead of cutting, as in the case of traditional approaches. The patients also enjoy expedited recovery and return to activities they enjoy. They enjoy early weight-bearing with fewer hip precautions like lying on back with a pillow in between the legs.

Rasp for preparing the femoral canal during hip replacement surgery

Rasp for preparing the femoral canal during hip replacement surgery

The images shows an instrument used in hip replacement surgery. The rasp has grooved surface to prepare the femoral canal to receive the prosthetic implant. The upper part has an attachment for handle to serially prepare the canal. once the final rasp is inserted for preparation, a trail head may be attached to the rasp to look for stability of the prosthetic implant.

MAKOplasty System

CT scan of the patient’s hip is taken several weeks before the surgery which is uploaded to the MAKO system. The CT scan images are then used to generate 3D models of the hip of the patient. This the accurate anatomy of the patient’s hip to help guide the surgeon. 

The 3 D models are used to create a customized surgical plan. Each plan is individualized according to the patient’s anatomy. During the surgery, the surgeon uses the MAKO powered Robotic Arm Interactive Orthopaedic System to generate anatomical guidelines in the patient’s hip. The System then guides the surgeon for accurate placement of the implant position removing only the diseased bone.

The robotic arm does not perform the surgery or make independent decisions. The surgeon uses the robotic arms guidance making decisions. The surgeon remains in control of the system for every decision being made and can modify the system’s guidelines intraoperatively. 


Compared to traditional surgical techniques, Anterior Hip replacement assisted work MAKO System offers several benefits:

  • Precise alignment and placement of the implant components based on patient-specific anatomy. 
  • Removal of only diseased bone and preservation of bone stock. 
  • Reduced blood loss during the surgery. 
  • Duplication of the biomechanics of the hip joint leading to the feeling of a natural hip. 
  • Decreased rate of complications such as hip dislocation or leg length discrepancy. 


As with any hip replacement, there are potential complications that are discussed by the operating surgeon. There can be complications such as blood clots in the legs, pulmonary embolism, leg length discrepancy, dislocation, bone fracture, pain, infection, and nerve/vascular damage. 


MAKOplasty anterior Hip replacement is an excellent option for relief of hip pain when indicated. Precise placement of components with a personalized surgical plan ensures the best outcomes of surgery and an expedited recovery. 

Patients return to their previous activities sooner with a pain-free and natural feeling hip joint. Robotic innovations in other endeavors outside the operating room (OR) are making giant leaps. MAKOplasty System in OR offers precise surgical techniques that can be duplicated in every surgery. 

My name is Dr. Suhirad Khokhar, and am an orthopaedic surgeon. I completed my MBBS (Bachelor of Medicine & Bachelor of Surgery) at Govt. Medical College, Patiala, India.

I specialize in musculoskeletal disorders and their management, and have personally approved of and written this content.

My profile page has all of my educational information, work experience, and all the pages on this site that I've contributed to.