How Does Robotic Hip Replacement Actually Work?

A Surgeon Explains MAKO® Robotic-Assisted Hip Replacement

Robotic-assisted hip replacement combines a preoperative CT scan with advanced surgical planning and intraoperative guidance to help optimize implant size and position. Throughout the procedure, the surgeon performs every step of the operation and remains in complete control of all surgical decisions.

Robotic-assisted hip replacement combines a personalized 3D surgical plan with real-time guidance to help your surgeon perform your procedure with greater precision.

If you're considering a hip replacement, you've probably heard about robotic surgery. But what exactly does the robot do?

Does it perform the surgery?

Does it make the operation safer?

Is it actually better than traditional hip replacement?

These are some of the most common questions I hear from patients in Danbury, New Milford, Southbury, and throughout western Connecticut and nearby New York.

The answer surprises many people.

Despite the name, the robot never performs the surgery.

Instead, robotic-assisted technology allows me to create a personalized surgical plan based on your unique anatomy and provides real-time guidance during surgery. Think of it as an incredibly advanced navigation system that helps improve precision while keeping the surgeon in complete control throughout the procedure.

In my practice, I use the Stryker Mako SmartRobotics system for many hip replacements because it helps me customize every operation to the individual patient.

What Is Robotic-Assisted Hip Replacement?

A hip replacement removes the damaged ball-and-socket joint and replaces it with artificial components designed to restore movement and relieve pain.

The difference with robotic-assisted surgery is how the operation is planned and performed.

Traditional hip replacement relies on X-rays, anatomical landmarks, and the surgeon's experience to determine implant size and positioning.

With MAKO robotic technology, we add another level of precision.

Before surgery, you undergo a specialized CT scan that creates a detailed three-dimensional model of your pelvis and femur.

Instead of estimating your anatomy, I can evaluate your actual bone structure in three dimensions before surgery even begins.

That means your operation is planned specifically for your hip.

How Does MAKO Robotic Hip Replacement Work?

Step 1: Your Hip Is Mapped in 3D

Everything begins with a CT scan.

The MAKO software creates a highly detailed 3-dimensional model of your hip, allowing me to study your anatomy from every angle before surgery.

During the planning process, I develop a personalized surgical plan based on your anatomy. This includes selecting the anticipated implant size and position while evaluating important factors such as:

• Anticipated implant size

• Planned implant orientation

• Hip center restoration

• Leg length

• Femoral offset

• Joint stability

• Range of motion

• Bone preservation

These preoperative measurements provide a roadmap for surgery, but they are confirmed and, when necessary, refined during the operation based on your anatomy, implant trialing, and real-time assessment.

Rather than making these decisions during surgery alone, much of the planning has already been completed beforehand.

Step 2: A Personalized Surgical Plan

One of the greatest advantages of robotic-assisted hip replacement is the ability to personalize the procedure to each patient.

No two hips are exactly alike. Differences in pelvic anatomy, bone shape, bone quality, leg length, and hip biomechanics mean that a surgical plan should be tailored to the individual rather than based on standardized measurements.

Using your CT scan, I develop a personalized surgical plan that serves as a roadmap for surgery. This allows me to evaluate implant size, position, and alignment before the procedure while planning to restore your hip anatomy as accurately as possible.

Although the plan is created before surgery, it is confirmed and refined during the operation based on your anatomy, implant trialing, and real-time assessment.

This combination of detailed preoperative planning and intraoperative decision-making is one of the reasons robotic-assisted technology has become such a valuable tool in modern hip replacement surgery.

Step 3: Real-Time Guidance During Surgery

Once you're asleep in the operating room, small temporary tracking arrays are attached to the pelvis and femur. These trackers allow the MAKO system to register your anatomy and align it with the personalized surgical plan created before surgery.

As I perform the procedure, the system displays real-time information about implant position, leg length, hip offset, and component orientation relative to the preoperative plan. This allows me to verify important measurements throughout the operation while making surgical decisions based on your anatomy and the findings during surgery.

Rather than replacing surgical judgment, MAKO serves as an advanced navigation tool. It provides objective data that complements my experience and helps me reproduce the personalized plan as accurately as possible.

The robot never makes decisions. The robot never performs the surgery.

Every step is performed by the surgeon.

Step 4: Implant Placement

One of the most important goals of hip replacement is restoring your hip's anatomy as accurately as possible. The position of the implants can influence several important aspects of your outcome, including:

• Hip stability

• Leg length

• Range of motion

• Risk of impingement

• Risk of dislocation

• Long-term implant function

One of the advantages of MAKO technology is the ability to compare the position of the implants with the personalized surgical plan throughout the procedure. This provides real-time measurements of parameters such as leg length, hip offset, implant orientation, and joint stability before the final implants are placed.

These objective measurements complement my intraoperative assessment and help me reproduce the surgical plan with a high degree of precision while tailoring the reconstruction to your individual anatomy.

Is Robotic Hip Replacement Better?

This is probably the question patients ask most often.

The honest answer is: Robotic technology is an advanced tool—not a guarantee of a better outcome.

Traditional hip replacement remains an excellent operation with a long history of successful outcomes.

However, research has consistently shown that robotic-assisted systems like MAKO improve the accuracy and consistency of implant positioning compared with conventional techniques.

That precision may help optimize hip mechanics, reduce the likelihood of implant malposition, and improve the reproducibility of surgery. Some studies have also found lower rates of implant positioning outliers and improved restoration of anatomy. Long-term research is ongoing to determine whether these technical advantages translate into even better outcomes over decades.

At the end of the day, technology complements—but never replaces—good surgical judgment and experience.

What Are the Advantages of MAKO Robotic Hip Replacement?

Personalized Surgery

Your surgical plan is based on your own anatomy using a three-dimensional CT scan rather than generalized measurements.

More Accurate Implant Positioning

Robotic guidance helps reproduce the preoperative plan with a high degree of precision, which is important because implant position influences stability, motion, and long-term function.

Real-Time Measurements

Throughout surgery, I can evaluate leg length, offset, implant orientation, and hip stability before the final implants are inserted.

Greater Surgical Consistency

The robotic system provides continuous feedback throughout the procedure, helping maintain consistency from the surgical plan to the final implant placement.

Bone Preservation

Precise planning and controlled bone preparation help preserve healthy bone while preparing the hip for the implants.

Why I Use MAKO Technology

Patients often ask whether I use robotic technology because it's "new."

The answer is no.

I don't use robotic technology because it's the newest trend—I use it because I believe it helps me personalize each operation and execute the surgical plan with greater precision. It's another tool that provides valuable information during surgery while allowing me to tailor the reconstruction to each patient's unique anatomy.

Combined with modern implants, evidence-based recovery protocols, and the direct anterior approach for many patients, MAKO technology is one more way I strive to deliver personalized hip replacement surgery tailored to each individual patient.

Does the Robot Replace the Surgeon?

Absolutely not.

This is one of the biggest misconceptions about robotic-assisted surgery.

The robot:

• Does not make decisions.

• Does not perform the operation.

• Does not place the implants.

• Does not operate independently.

The surgeon remains in complete control from beginning to end.

The robotic system simply provides information, guidance, and precision that are not available with conventional instruments alone.

Is Robotic Hip Replacement Right for Everyone?

Not necessarily.

Many patients are excellent candidates for robotic-assisted hip replacement, while others may benefit from different techniques depending on their anatomy, previous surgeries, bone quality, or specific diagnosis.

Choosing the right surgical approach—including whether to use robotic assistance—should always be individualized.

During your consultation, we'll review your imaging, discuss your goals, and determine the treatment plan that's best for you.

My Approach to Hip Replacement

Every patient comes to surgery with different anatomy, different goals, and different expectations.

For that reason, I don't believe there is a "one-size-fits-all" approach to hip replacement.

I combine careful preoperative planning, modern implant technology, evidence-based recovery protocols, and robotic assistance when appropriate to create a treatment plan tailored to each individual.

My goal is simple:

Relieve pain.

Restore mobility.

Help you return to the activities that matter most.

Frequently Asked Questions

Does robotic hip replacement take longer?

Once the surgical team is experienced with the technology, operative time is often similar to traditional hip replacement. The additional planning occurs before surgery using your CT scan.

Will robotic hip replacement help me recover faster?

Recovery depends on many factors, including your overall health, surgical technique, pain management, and rehabilitation. Robotic assistance primarily aims to improve surgical precision rather than directly accelerate recovery.

Is robotic hip replacement more accurate?

Multiple studies have demonstrated that robotic-assisted systems improve the accuracy and consistency of implant positioning compared with conventional techniques.

Does insurance cover MAKO robotic hip replacement?

In most cases, yes. Robotic assistance is generally considered part of the surgical technique rather than a separate procedure, so it is typically covered when hip replacement itself is covered by your insurance.

Considering Hip Replacement?

If hip arthritis is limiting your daily activities, robotic-assisted hip replacement may be an excellent option to discuss.

During your consultation, we'll review your X-rays, evaluate your hip, talk about your goals, and determine whether MAKO robotic-assisted surgery is appropriate for you.

If you're looking for a robotic hip replacement surgeon in Danbury, New Milford, Southbury, or western Connecticut, I'd be happy to discuss your options and answer your questions.

Call: 203-797-1500

Visit: JenniferWoodMD.com

Jennifer Wood, MD, FAAOS is a board-certified orthopedic surgeon specializing exclusively in hip and knee replacement in Danbury, Southbury, and New Milford, Connecticut. She performs robotic-assisted hip replacement using CT-based surgical planning to help optimize implant positioning while tailoring each procedure to the individual patient's anatomy. As a specialist in joint replacement, Dr. Wood also offers robotic-assisted knee replacement, muscle-sparing knee replacement, outpatient joint replacement, and revision hip and knee surgery.