Robotic knee surgery wars

The world’s top medical technology companies are turning to robots to help with complex knee surgery, promising quicker procedures and better results in operations that often leave patients dissatisfied.

Demand for artificial replacement joints is growing fast, as baby boomers’ knees and hips wear out, but according to a report in the Star, for the past 15 years rival firms have failed to deliver a technological advance to gain them significant market share.

Now US-based Stryker and Britain’s Smith & Nephew believe that is about to change, as robots give them an edge. Stryker is leading the charge with its MAKO robotic arm, a platform it acquired for US$1.65 billion in 2013 and which has pioneered robot-assisted whole-knee operations by determining optimal positioning and then helping with bone cutting. But it faces competition from smaller rival Smith & Nephew, which recently launched a cheaper product called Navio for total knee replacements in the United States. It costs about less than half of Stryker’s installation price.

Robots should mean less trauma to patients and faster recovery, although they still need to prove themselves in definitive clinical studies, which will not report results for a couple of years.

Fares Haddad, a consultant surgeon at University College London Hospitals, is one of the first in Britain to use the new robots and has been impressed. However, he agrees healthcare providers need decisive data to prove they are worth an investment that can be as much as US$1 million for each robot. Stryker expects its MAKO system to start delivering market share gains from the end of 2017.

Analysts at Morgan Stanley believe robots have the potential to disrupt a market in artificial joints that has arguably become commoditised, with no knee or hip implant emerging as supreme in recent years.

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