MAKO Robotic-Assisted Surgery

Robotic-Assisted Hip & Knee Replacement

Evidence-based information about MAKO robotic-assisted joint replacement, including what the technology does, where it can add precision and what it cannot promise.

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100+ MAKO proceduresPersonally performed · surgeon remains in control

Quick Answer

What does the robot actually do?

MAKO is a surgeon-controlled assistive system. It can use CT-based three-dimensional planning and robotic guidance to help execute a planned hip or knee replacement with high precision.

It can support

3D pre-operative planning
implant sizing and positioning decisions
controlled bone preparation within the surgical plan
reproducible execution of the plan

It does not operate independently. The surgeon makes the clinical decisions and performs the operation.

Mr Mohamed Mussa

Robotic experience in context

Mr Mussa is a certified robotic surgeon and has personally performed more than 100 MAKO robotic-assisted joint replacements. The technology is used selectively when it adds value to planning and execution.

PlanReview CT-based anatomy and define a patient-specific surgical plan.

CheckUse intra-operative information to confirm the plan remains appropriate.

ExecuteUse robotic assistance to help carry out the planned preparation while the surgeon remains in control.

What does current evidence show?

NICE's current early-value assessment allows specified robot-assisted orthopaedic systems, including MAKO, to be used while further evidence is generated. NICE notes that robotic systems aim to improve precision of implant positioning, while the longer-term clinical advantages remain an evolving area of evidence.

Knee replacement

The UK RACER-Knee randomised trial, published in The Lancet in September 2026, found that MAKO robotic-assisted total knee replacement did not provide a clinically meaningful patient-reported benefit at 12 months compared with conventional instruments. Safety was similar and robotic surgery was more costly.

Hip replacement

Randomised and systematic-review evidence generally supports improved reproducibility of component positioning. However, evidence for clear long-term clinical superiority remains less certain, and results should not be over-interpreted.

What this means for you: robotics can support planning and precision, but cannot guarantee less pain, faster recovery, fewer complications or a longer-lasting implant.

Robotic hip or robotic knee?

The planning questions and evidence differ between hip and knee replacement, so each has its own detailed page.

Evidence & Further Reading

Independent sources

We prioritise UK guidance and peer-reviewed evidence over manufacturer marketing.

NICE HTG743 — Robot-assisted orthopaedic surgery

Conditional use during evidence generation and the current evidence base.

View NICE guidance →

BOA — Patient guide to robot-assisted hip and knee arthroplasty

Independent patient information from the British Orthopaedic Association.

View BOA information →

RACER-Knee — Lancet 2026

Pragmatic UK randomised controlled trial of MAKO total knee replacement.

View PubMed record →

Common Questions

Robotic surgery FAQs

Does the robot perform the operation?

No. The surgeon remains responsible for the plan, decisions and operation. The robotic system assists with defined parts of the procedure.

Is robotic surgery always the best option?

No. Suitability depends on the operation, anatomy, implants and individual circumstances. Conventional joint replacement remains a well-established option.

Does greater precision automatically mean a better outcome?

No. Precision is one part of successful joint replacement. Patient selection, surgical judgement, soft-tissue management, implant choice and rehabilitation also matter.

Robotic or conventional joint replacement?

Both approaches rely on your surgeon’s judgement, careful planning and rehabilitation. This comparison can help you prepare questions for your consultation.

How the two approaches differ
Question	Conventional surgery	MAKO-assisted surgery
Who performs the operation?	The surgeon.	The surgeon, supported by the robotic system.
How is it planned?	Clinical assessment and imaging guide the plan.	CT-based 3D planning adds detail about your anatomy.
How are instruments guided?	The surgeon uses conventional surgical instruments and guides.	The surgeon uses robotic assistance for defined parts of bone preparation and implant positioning.
What determines the choice?	Your anatomy, operation, implant requirements and clinical circumstances.	The same considerations, plus system suitability, availability and costs.

More precise execution of a plan does not guarantee a better recovery or a longer-lasting implant. Read the separate robotic hip and robotic knee pages for the evidence relevant to each operation.