Makoplasty Anterior Hip Replacement

This is a hip replacement that combines two modern features: the anterior approach (reaching the hip from the front, which spares muscles and speeds recovery) and robotic assistance, using a system called MAKO. The key idea is precision. Before surgery, a detailed scan of your hip is used to build a 3D model and a surgical plan made specifically for your anatomy. During the operation, a robotic arm guides the surgeon to place the new hip parts exactly where the plan calls for. One important point: the robot doesn’t perform the surgery, your surgeon does, staying in full control the whole time and using the robot as a highly percise guide. Getting the parts placed accurately helps the new hip feel natural, last longer, and avoid problems like dislocation or uneven leg length. This page explains the condition it treats, how the robotic surgery works, and what to expect.

What condition does this treat:

This treats hip pain and stiffness caused by a damaged hip joint, most often from arthritis. Several things can lead to it:

• Osteoarthritis. This is due to common wear-and-tear breakdown of the joint’s smooth cartilage, and the most common reason for hip replacement.
• Post-traumatic arthritis. This is arthritis that develops after an previous injury or fracture.
• Inflammatory arthritis. This is caused by conditions where the body’s own immune system damages the joint.
• Hip dysplasia. This is a hip that didn’t form as we would normally expect. These are usual related to genetics and childhood factors, that result in an abnormal hip.

When the cushioning in the joint wears down, the bones rub and the hip becomes painful and stiff, making everyday movement hard.

When should you consider surgery:

As with any hip replacement, surgery comes after non-surgical treatments have been tried for several months, and haven’t given enough relief. This includes medication, physical therapy, activity modification, weight reduction, assistive devices, and injections. If your hip pain persists despite non-operative treatment, and getting in the way of daily life, a hip replacement may help. The robotic, front-approach version is one way to do that replacement. Whether it’s the right fit for you depends on your anatomy and your surgeon’s assessment.

What happens during surgery:

The process actually starts a few weeks before surgery. You get a detailed scan (CT scan) of your hip. That scan is turned into a 3D model of your exact anatomy, and the surgeon uses it to build a personalized plan for where each hip replacement part should go.

On the day of surgery, the surgeon reaches the hip from the front, gently separating the muscles instead of cutting through them. Then, using the robotic arm as a guide, we:

1. Remove only the worn, arthritic bone. The robotic system helps avoid taking out more healthy bone than needed.
2. Place a metal cup into the socket, lined with a smooth plastic insert that lets the joint glide.
3. Fit a stem into the top of the thigh bone and attach a new ball on top.
4. Check that everything moves smoothly and sits correctly, measure the limb parameters, then close up the incision.

Throughout, the robotic arm gives the surgeon real-time guidance to match the pre-made plan with the real time positioning. However, the surgeon makes every decision and can adjust the plan during surgery as needed. The robot never acts on its own.

X-ray showing robotic total hip replacement

What does recovery look like:

Because this uses the front (anterior) approach, recovery tends to be quicker than with older techniques that cut through more muscle. Many people can put weight on the leg early with fewer of the strict “hip precautions” that other approaches require. Recovery focuses on physical therapy to rebuild strength and movement. Most patients work their way back to the activities they enjoy. The precise placement the robot helps with can support a smoother recovery and a hip that feels more natural. Your exact timeline depends on your health and activity level, and your surgeon will give you a plan. Generally, you are up and walking the same day of surgery, and might be able to go home the same day of surgery. At 6 weeks most patients are walking relatively pain free. They have graduated from canes or walkers. Most are driving and back at work. By 3 months most patients have returned to their usual activities. However it may take a full year to fully recover after surgery.

What are the major risks and complications:

Even with robotic assistance, this is still major surgery and carries the same general risks as any hip replacement. Your surgeon will go over these with you. They include:

• Blood clots in the leg, which can be dangerous if one travels to the lungs. We give you medicaiton to prevent this.
• Infection at the wound or deeper around the implant. If you have a deep infection, it may warrant another operation.
• Dislocation, where the new ball slips out of the socket. Usually this required putting the hip back in place under sedation.
• A bone fracture around the implant. Usually this required additional surgery
• Nerve or blood vessel injury near the surgical area. This typically resolves over time.
• Uneven leg length is possible, but rare with the use of robotics.
• Ongoing pain is rare but possible

The goal of the robotic, patient-specific planning is to lower the chances of some of these by placing the components more precisely. This particularly effects the risk of dislocation, uneven leg length, and patient satisfaction (early on).

What if you don’t have surgery:

Surgery isn’t required, and many people manage hip arthritis for a long time with medication, physical therapy, and injections. Those are reasonable first steps. But arthritis doesn’t heal on its own. It is a slow, progressive, chronic condition. The joint generally keeps wearing down, so for many people the pain and stiffness slowly worsen and everyday activities get harder over time. Non-surgical care can ease symptoms but doesn’t repair the underlying damage. It’s also worth remembering that the robotic anterior technique is just one way to do a hip replacement. If you do decide on surgery, your surgeon can talk you through whether this approach is the best fit. When and how to proceed is a decision to make together based on your symptoms and how much your hip is affecting your life.

Benefits of anterior robotic surgery:

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. 
• Better patient pain and function scores in the early periods after surgery
• Better component placement, particularly in cases of trauma, previous hardware, deformity, and hip dysplasia