Total knee philosophy

The addition of the Mako Total Knee application with Stryker’s market-leading Triathlon Total Knee System expands the current Mako offering to provide a comprehensive solution in the robotic-arm assisted joint replacement service line. The total knee application was developed based on the Mako Partial Knee application. The combination of the Mako Partial Knee and Total Knee applications provides surgeons with the ability to offer patients a full range of knee replacement surgeries.

The outcomes you can achieve with the Mako Total Knee application has the potential to transform the future of your orthopaedic service line.

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Market overview

In 2017, over 705,00069 primary TKA procedures are forecasted to be completed in the United States. This number is expected to grow to 3.4870 million procedures by 2030, which represents 673%70 procedural growth.

Surgeons and hospitals are tasked with meeting the large increase in demand for orthopaedic procedures, while driving towards quality improvement to meet the needs of an evolving healthcare landscape.

Demand for orthopaedic procedures in US

  • THA:↑ 174% by 203070
  • TKA:↑ 673% by 203070
  • PKA: Partial knee replacement surgery is currently underutilized, accounting for only 8% of knee replacement procedures71
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Drive towards quality enhancements

  • Enhance patient experience
  • Reduce per capita cost
  • Value based healthcare
  • Bundled reimbursement
  • Economic burden of OA in the US: $60 billion per year72

Total knee clinical considerations

Poor outcomes after TKA

Range from 7-20%73 and include:

  • Dissatisfaction102
  • Pain73
  • Stiffness73
  • Poor function73
  • 5.6% of patients reported worse patient reported outcome measures (PROM) at 6-months postoperatively compared to pre-op73

Potential causes of TKA revision

  • Aseptic loosening75
  • Infection75
  • Patello femoral pain75
  • Pain, instability, stiffness75
    • Increasing failure mode since the start of national joint registries as compared to aseptic loosening
    • Younger cohort leads to higher demand and expectations
  • Fehring et. al concluded the overall rate of revision could be reduced by 25% by careful ligament balancing alone.75

Indicators of revision following TKA

  • Revision is the benchmark outcome by which survival of orthopaedic implants are assessed74
  • Used as a sole endpoint underestimates the volume of patients with pain or poor function74
  • Price et al stated 12 year survivorship is 82% if revision was the endpoint74
  • Survivorship decreased to 59% if moderate/severe pain was included74

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