Is Mako the real deal?

Discussion in 'Stryker' started by Anonymous, Apr 20, 2015 at 1:09 PM.

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  1. anonymous

    anonymous Guest

    Investor here. Stock performing quite nicely. Mako sales in Q1 low but traditionally slow Q1-Q3 and then Q4 explosion? What's the latest from the field? Corporate seems to be taking their time with rolling out Triathlon. Are there any negatives out there that corporate is not communicating to investor public?
     

  2. anonymous

    anonymous Guest

    There is absolutely nothing robotic about Mako. It is an articulating arm with a burr on the end that shuts down when it leaves the cut perimeter designated by the computer software referenced by the CT scan. This "robot" is nothing exciting and costs $1m. The physician moves his hand around with the but like he's using an eraser. That's it. The excitement will not last and this will be a gimmick to grab market share and waste capital money
     
  3. anonymous

    anonymous Guest


    Uh...so your saying its a robot? it doesn't shut down when it leaves the cut perimeter...it is locked into that space with the ROBOTIC ARM. the physician moves his hand around, being kept inside the resection space created using the CT by...yep...the ROBOTIC ARM. educate yourself.
     
  4. anonymous

    anonymous Guest

    Don't robots move on their own? If I had a toy, and it moved on its own, I would call it a robot. If I have to control it, it's called remote control.
     
  5. anonymous

    anonymous Guest

    autonomous active robots move on their own, passive robots do not. We are not talking about toys. We are talking about the most sophisticated technology orthopaedics has ever seen. The robotic arm is the technology that allows the surgeon to only operate within the determined plan - "move on its own" in this case, the robot is actively keeping the saw, reamer or burr within a surgeon planned space. The automation of this robot is not in the execution, which the surgeon does, it is the automation of the space that the cutting tool is able to be used within.
     
  6. anonymous

    anonymous Guest

    All of this does not matter if we can't fix the quality issues we are experiencing with this pos right now.
     
  7. anonymous

    anonymous Guest

    so, the space is automated? Sounds like navigation. Robot is moved? Sounds like a navigated burr. Isn't that what Blue belt is too? A glorified navigated burr?
     
  8. anonymous

    anonymous Guest

    It is navigation. It is image based (accuracy) Robotic-Arm-Assisted navigation. The difference between blue belt and mako is not the navigation part...they are both navigation, however, one is imageless (without CT or real anatomy) one is image based (with CT). Having the CT removes the variability from what is being fed into the computer, which will remove the variability of the information that comes out of the computer. The issue with navigation has always been the inability to gather accurate anatomic data to work with and then executing on that data.

    The arm makes sure that the perfect image based navigated plan, now gets executed with sub mm accuracy. So, of course, the robot is glorified navigation - navigation is not a bad thing...Image based navigation is the holy grail of accuracy. The difference between blue belt and mako are:

    Imageless vs image based navigation - accuracy of plan
    Robotic-arm assisted execution - precision execution vs blue belt navigated hand tool with nothing keeping it in the cut plane
    Blue belt cannot do total hip
    blue belt has two indications on partial vs. stryker has four
    Blue belt TKA is an imageless navigated placement of cutting blocks - which is EXACTLY what has been done for the last 15 years in navigation
    Stryker robotic arm assisted TKA is an image based navigated plan and executed operation with no cutting blocks

    these two technologies are vastly different.
     
  9. anonymous

    anonymous Guest

    You should do your research before you claim that imageless navigation is more inaccurate. A quick review of published studies to date would show that in most cases, imageless is as accurate as image-based.
     
  10. anonymous

    anonymous Guest

    still, calling it a robot is a stretch. Sure, it has accuracy, and yes, uses a fancy arm and burr, but it's not a real robot. That is just a marketing ploy...it is navigation with a controlled workspace. I would almost think that Blue Belt has an advantage on totals because the cuts will be good. The burr leaves a lot of peaks and valleys, which seem to lack precision. Omni has a good design, but I haven't heard much about it in the market.
     
  11. anonymous

    anonymous Guest

    The StrykerMako Total knee is cut with a saw, not a burr....the difference between the mako and blue belt is that the mako tka will be cut without any blocks and the blue belt is simply the use of the burr to place standard cutting blocks which are then cut with a standard saw. Blue belt is navigated cutting blocks....which is nothing new.

    I'm just curious....what do you define as robotic? The FDA defined our system as robotic...it's in the approval...it is not, however in the blue belt approval. This is not marketing...this is actual science that has been reviewed and accepted as robotic. I am unsrure as to what you are questioning.

    The burr does not lack precision....our two year revision rate is less that a percent...five years we have zero reported failures. If the burr led to implant fit or stability issues we would have seen them by now.
     
  12. anonymous

    anonymous Guest

    Every single robotic technology being launched into the surgical space is using some type of image. Clearly there is a benefit to having the actual anatomic structures via image vs interoperative input. You can get a good idea of things, but with the CT we have the actual bony morphology which allows us to make real decisions on where the bone is and where the mechanical and anatomic axis really lie.

    It's not only about the image....blue belt is not controlled execution. it's a navigated hand piece which is ok, but not nearly as accurate and reproducible as the arm. This is why for total knees they are not going to use the handpiece to make cuts. They will only be using the navigated burr to place holes for cutting blocks which will be used with standard saws. The StrykerMako TKA is cut with the arm with no blocks. Bluebelt is a navigation system, which in my opinion is better than manual instruments, but no where near the capabilities of robotic-arm-assisted.
     
  13. anonymous

    anonymous Guest

    If insurance still won't pay for the CT. What's the fucking point? Left alot of sour tastes in the surgeons mouth over this issue still.
     
  14. anonymous

    anonymous Guest

    StrykerMako - CT based
    Think Surgical - CT based
    Mazor - CT based
    Globus - CT based
    Rosa - CT based

    I guess every other robotic company is just totally out of luck. The point is that in order for the robot to deliver the absolute precision it is designed to, it needs definitive anatomic data. More accurate placement of devices will lead to lower overall cost to the system and better outcomes for patients. This argument was reasonable when Mako was the only player, but the robotic market is growing rapidly, proving the need not only for the scan, but for surgical robotics in general.
     
  15. anonymous

    anonymous Guest

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  16. anonymous

    anonymous Guest

    Smith and F U beat us to the punch with a Tka? Is it really robotics? It burrs the position of the blocks. Sounds like navigation with a hand piece that moves.
     
  17. anonymous

    anonymous Guest

    What smith and nephew is doing is no different than what Stryker has been doing with navigation since 1997. Old technology.
     
  18. anonymous

    anonymous Guest

    Can anyone say that any of their high volume surgeons are going to use these devices unless their getting paid to do so.
     
  19. anonymous

    anonymous Guest

    I don't think even low volume surgeons are going to use it. How easy is it to get a doc to re-pin a block for an extra cut? Most just free hand that shit. Now, you want them to fix arrays, take points, play around with nav for block position, and then pin it? Sounds like Brainlab with extra futz factor. It makes for nice headlines, but when you look at it closely, it seems like wasted time and money.
     
  20. anonymous

    anonymous Guest

    Actually, No, we don't want them to pin ANY blocks. That's the whole point. No blocks. Just the saw on the arm making perfect cuts. Pinning a block to make an extra cut isn't the issue, it's how does that extra cut effect the joint balance and is it the right thing to do.

    The results we have seen with thousands of partials is not about headlines. It's about lower revision rates, fewer complications and better out comes for patients. This is not a marketing tool, it's a surgical optimization tool that is proving itself out.