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Short answer: Mako SmartRobotics helps a surgeon plan and guide joint-replacement surgery; it does not operate on its own. For total knee replacement, the strongest current comparison in the available evidence—a 2026 randomized trial—found no clinically meaningful patient-reported advantage at 12 months over conventional instruments. That does not prove the approaches are equivalent for every patient or procedure, but it does mean Mako should not be presented as a guarantee of less pain, faster recovery, fewer complications, or a longer-lasting implant.
What is the difference between Mako and manual joint replacement?
Both approaches involve a surgeon performing the joint replacement. Mako changes how the surgeon plans and guides parts of the operation: Stryker describes it as combining a 3D model made from a preoperative CT scan, AccuStop haptic technology, and data analytics. During surgery, the robotic arm and haptic boundaries help guide the surgeon’s bone preparation toward the plan. The system assists the surgeon; it does not make the surgical decisions or perform the operation autonomously.
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| What to compare | Mako-assisted surgery | Conventional-instrument surgery |
|---|---|---|
| Planning and guidance | CT-based 3D planning and robotic-arm guidance with haptic boundaries, according to Stryker’s Mako overview. | Uses conventional surgical instruments; no single planning workflow applies to all surgeons or procedures. |
| Who performs the operation | The surgeon performs the operation, using Mako as an aid. | The surgeon performs the operation using conventional instruments. |
| Patient benefit in the 2026 total-knee randomized trial | No clinically meaningful patient-reported benefit at 12 months compared with conventional instruments. | No clinically meaningful disadvantage at 12 months was demonstrated against Mako in that trial. |
| Long-term implant life | Not established by the cited comparison. | Not established by the cited comparison. |
The comparison is meaningful only when the same joint and procedure are being considered. A partial knee replacement, total knee replacement, and total hip replacement are not interchangeable comparisons.
Is Mako robotic knee replacement better than regular knee replacement?
For total knee replacement, the best direct evidence is the 2026 RACER-Knee pragmatic, multicentre randomized controlled trial. Investigators screened 807 people with advanced knee osteoarthritis and randomized 339: 168 to robotic-arm-assisted surgery and 171 to conventional instruments.
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At 12 months, the adjusted difference in Forgotten Joint Score was −1.5 points (95% confidence interval −7.5 to 4.5; p=0.62), favoring conventional surgery. The trial report concluded that Mako-assisted surgery did not provide a clinically meaningful patient benefit at that point. Sixteen participants in each group had one serious adverse event. The study’s cost finding was that robotic-assisted surgery was more costly in its UK setting; it is not a quote for an individual patient or a finding that can be applied to every country or insurer. Source: RACER-Knee investigators, 2026, PubMed record.
A smaller study points to possible early differences, but cannot overturn the randomized trial’s broader result. Ma and colleagues’ single-centre retrospective study, published in International Orthopaedics on 14 June 2024, compared 22 Mako-assisted with 26 conventional total knee replacements in people with end-stage knee osteoarthritis. The Mako group had lower pain scores at 24, 48, and 72 hours and higher scores on selected function and Forgotten Joint Score measures at one and three months. At one month, 86.4% of the Mako group and 76.9% of the conventional group had a hip-knee-ankle angle under three degrees. One conventional-group patient had postoperative stiffness that resolved with physical therapy; complication rates did not differ significantly. The small sample, retrospective design, and short follow-up limit what these results can establish.
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These studies measure different things at different times. Early pain or alignment results are not proof of better long-term function, fewer revisions, or a more durable implant. Stryker also presents favorable findings from selected Mako studies, including early recovery findings for partial knee replacement; those manufacturer-curated summaries concern different procedures and study designs and should not be treated as evidence about total knee replacement. A 2025 systematic-review search-result summary reports some medium-term functional outcomes favoring Mako but says further randomized trials are needed; detailed numerical results are not established here.
Does Mako knee replacement heal faster?
The evidence does not establish that it does. The 2024 retrospective study reported lower pain scores during the first 72 hours and some better selected measures at one and three months, but it included only 48 procedures and followed patients for a short period. The 2026 randomized trial found no clinically meaningful patient-reported advantage at 12 months. Neither result proves that an individual will recover faster with one approach.
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Precision and alignment can matter to the operation, but they are intermediate measures—not substitutes for outcomes a patient experiences. Pain, mobility, complications, revision, recovery time, and implant longevity each require evidence of their own.
Is Mako robotic hip replacement worth it?
Do not use the total-knee findings to decide whether to have robotic hip replacement. Stryker’s patient information describes a hip workflow that uses a preoperative CT scan and lists studies comparing robotic-arm-assisted and manual hip replacement. The evidence summarized here does not establish a strong, current randomized comparison for hip surgery, so it cannot support a definitive claim that Mako hip replacement is superior.
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For a hip operation, the relevant details include the exact procedure, surgical approach, implant, the surgeon’s experience with that technique, and your anatomy and health. Ask the surgeon to explain the expected benefit in your specific case rather than relying on claims about robotic surgery in general.
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What risks and costs should you ask about?
Robotic assistance does not remove the risks of joint replacement. Stryker’s hip replacement information lists possible risks including pain, infection, bone fracture, leg-length change, joint stiffness, blood clots, nerve injury, stroke, heart attack, and death. It also says outcomes vary and implant lifetime is limited. Your surgeon can explain which risks are most relevant to your health and procedure.
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The UK RACER-Knee trial found Mako-assisted total knee replacement more costly in that study context, but that finding does not tell you what you personally will owe. Charges, coverage, and any extra fee can depend on the surgeon’s practice, hospital, insurer, and location. Ask the surgeon’s office for an estimate and check coverage directly with your insurer.
Quick Recap
Questions to ask your orthopaedic surgeon
- Which exact operation are you recommending—total knee, partial knee, or total hip—and why?
- For someone with my anatomy and health history, what outcomes do you expect, and how do they compare with your results using conventional instruments?
- How many of this exact procedure have you performed with Mako, and who will perform each part of my operation?
- Would Mako change the implant, surgical approach, or rehabilitation plan in my case?
- What benefits and risks do you expect for me, and what evidence supports those expectations?
- What will I personally owe, and should I confirm coverage with my insurer?
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