Comparing Zimmer Biomet ROSA and Stryker Mako Robots in Knee Replacement Surgery

Robotic-assisted surgery has revolutionized the field of orthopedics by offering improved surgical accuracy and reducing reoperation rates. While the concept of robotic surgery might evoke images of autonomous robots performing procedures, it is crucial to recognize that these systems are guided by skilled surgeons. Joint replacement procedures, particularly knee arthroplasty, have witnessed significant advancements in robotic technologies. In this article, we will explore and compare two FDA-approved robotic surgical systems: Zimmer Biomet ROSA and Stryker Mako.

Stryker Mako: Precision and Flexibility
Stryker's Mako System, approved by the FDA in August 2015, is a robotics-assisted surgical platform that facilitates partial knee, total hip, and total knee replacements. The system's pre-operative planning process relies on a CT scan to generate a 3D model of the patient's bone structure, enabling accurate implant positioning. This personalized plan, unique to each patient, allows physicians to review and optimize the procedure before it takes place.

During the operation, real-time data is collected, and modifications can be made to achieve optimal implant placement. The Mako Total Knee platform, in particular, has gained significant demand among surgeons. Stryker's projected robotic sales in 2019 indicate strong interest in this technology. It's worth noting that Stryker acquired the original creator of the Mako technology, Mako Surgical Corporation, in 2013 for $1.65 billion.

Zimmer Biomet ROSA: Precision and Methodical Launch
Zimmer Biomet's ROSA Knee System received FDA approval more recently, in January 2019. Similar to Mako, this system assists in total knee replacements by aiding in bone resections and evaluating soft tissues for optimized implant positioning during surgery. However, Zimmer Biomet took a measured and disciplined approach to the launch of their robotic device.

Bryan Hanson, CEO of Zimmer Biomet, emphasized the company's commitment to a limited launch initially, ensuring proper education and service levels. After a successful limited launch period of approximately six months, the system would move into full launch status. This approach allows Zimmer Biomet to unleash the technology while ensuring a well-executed implementation. Furthermore, the ROSA system supports Zimmer Biomet's Persona®, Vanguard®, and NexGen® implant families, emphasizing personalization, surgical simplicity, and proven outcomes, respectively.

Distinguishing Factors
According to industry analyst Mike Matson, who reviewed the American Academy of Orthopedic Surgeons (AAOS) meeting in March, neither Mako nor ROSA exhibit clear superiority. Matson highlighted several key differences between the two systems.

Mako's robotic arm features a bone saw, while ROSA incorporates a cutting guide. Stryker's focus is on haptics as a differentiating factor, emphasizing improved outcomes. However, Zimmer Biomet argues that Mako's haptics can limit surgeons' control and their ability to complete bone cuts fully, which can be considered an advantage of ROSA.

Another significant distinction lies in the imaging technology used. Mako relies on CT scans for precise planning, while ROSA utilizes X-ray data or image-free analysis. Stryker may argue that CT scans offer greater accuracy, whereas Zimmer Biomet emphasizes the cost and time efficiency of their approach.

Zimmer Biomet's Edge and Mobile Health Compatibility
Zimmer Biomet CEO Bryan Hanson believes his company has an advantage in the field due to the widespread use of Zimmer devices in arthroplasty. This established presence provides an excellent opportunity for Zimmer Biomet to introduce robotics into the global knee replacement market, leveraging the trust and familiarity surgeons have with their implants.

Furthermore, Zimmer challenges Stryker 

with its mobile health compatibility. Zimmer Biomet has partnered with Apple to offer a smartphone app called mymobility, which enhances the connection between patients and surgeons. The app, compatible with iPhones and Apple Watches, serves to improve the overall patient experience by assisting them in preparing for their orthopedic procedure, such as knee replacement surgery with ROSA.

The mymobility app also supports patients during the post-operative phase by providing them with a platform to provide feedback and share continuous data with their physician. This continuous flow of information enables the healthcare team to monitor the patient's progress, enhance their care, and ensure a better outcome and higher satisfaction. Additionally, the app allows patients to securely communicate with their care team through messaging features, promoting effective and convenient communication.

The advent of robotic-assisted surgery has significantly transformed the landscape of orthopedics, particularly in knee replacement procedures. Both the Zimmer Biomet ROSA and Stryker Mako robots offer advanced technologies that contribute to improved surgical precision and patient outcomes. While the systems have distinct features, no clear superiority has been established between them.

Stryker's Mako system focuses on haptic feedback and precision, utilizing CT scan data for accurate planning, while Zimmer Biomet's ROSA system emphasizes methodical launch strategies and compatibility with their existing implant families. Furthermore, Zimmer Biomet distinguishes itself with its mobile health compatibility, partnering with Apple to provide the mymobility app, which enhances patient engagement and post-operative care.

As the field of robotic-assisted surgery continues to evolve, it is essential for surgeons and healthcare professionals to stay informed about the latest advancements and make informed decisions based on individual patient needs and surgical goals. The choice between the Zimmer Biomet ROSA and Stryker Mako robots ultimately depends on factors such as surgeon preference, clinical outcomes, and patient-specific requirements, ensuring that each patient receives the best possible care and surgical experience.

Source: Zimmer Biomet, Stryker