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Orthopaedics · UK

Mako robotic hip replacement, planned from your CT, placed to the millimetre.

A total hip replacement where a 3D plan is built from your CT and the Stryker Mako robotic arm haptically guides cup and stem placement to that plan - by a Mako-trained consultant hip surgeon, in a proper theatre, with an ERAS recovery pathway.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private Mako robotic hip replacement costs in the UK.

Indicative ranges across UK private providers. The Mako premium over a conventional THR is typically £2,000–£5,000.

In short

£15,000–£22,000, home in 1–3 days.

Procedure Indicative range
Mako robotic THR (uncemented) - self-pay £15,000–£22,000
Mako robotic THR (cemented) - self-pay £16,000–£23,000
Mako robotic THR - complex/dysplastic £18,000–£25,000
Conventional (non-robotic) THR - comparison £12,000–£18,000
Planning CT pelvis and hips (Mako protocol) £350–£600
Consultant hip consultation £250–£450

Prices vary by hospital, by the surgeon and anaesthetist, by implant choice (uncemented, cemented, hybrid; ceramic bearing) and by whether the case is straightforward or complex. Length of stay affects the final figure.

The problem

Cup mal-positioning is the single biggest reason hip replacements fail early.

A cup outside the accepted safe zone for inclination and version is the leading driver of dislocation, edge-loading, wear and revision. Mako’s case is a simple one: place it accurately every time, and restore leg length and offset while you are at it.

  • Cup within 3° of plan >95% of cases

    Manual technique hits the safe zone in 30–60% of cases; Mako’s CT-based plan and haptic guidance lift that figure above 95% in published series.

  • Leg length and offset, measured in real time

    A short leg after THR is a common patient grievance. Real-time intraoperative measurement makes clinically noticeable LLD less likely than with the manual technique.

  • Particularly useful for tricky anatomy

    Dysplasia, protrusio, prior fracture, big deformity, revision - cases where planning by eye is hardest are the cases Mako helps most.

When it helps

When a Mako THR is the right step.

The hip problems we see most, and the one red flag that means an emergency rather than an appointment.

  • End-stage hip osteoarthritis

    Bone-on-bone hip OA on X-ray with pain that stops you sleeping, walking or working - the standard THR indication.

  • Developmental dysplasia (DDH)

    A shallow or misshapen socket where cup position is difficult to plan by eye - Mako’s CT-based plan particularly helps.

  • Protrusio acetabuli

    A socket that has migrated medially into the pelvis - reconstructing anatomy accurately benefits from a 3D pre-op plan.

  • Leg length discrepancy

    A shorter leg on the arthritic side (or a longer one) - Mako measures leg length and offset in real time to restore them.

  • Avascular necrosis of the femoral head

    Bone death in the femoral head from steroids, alcohol, sickle cell or idiopathic causes - THR when collapse is advanced.

  • Post-traumatic hip arthritis

    Arthritis after a hip or acetabular fracture, where anatomy is distorted and planning matters more than usual.

  • Inflammatory hip arthritis

    Rheumatoid, ankylosing spondylitis or psoriatic arthritis destroying the hip despite medical therapy.

  • Red flag: hot, painful hip with fever

    Sudden severe hip pain with fever, redness or systemic upset can be septic arthritis or an infected implant - same-day A&E, not a clinic booking.

Procedure options

Mako is one option, not the only one.

What each option on the table actually involves - Mako variants, conventional THR, and the alternative robotic platforms.

  • Mako uncemented THR

    A press-fit titanium cup and stem, usually with a ceramic head on cross-linked polyethylene - the default for most active adults under 70.

  • Mako cemented THR

    Cup and/or stem cemented into bone - preferred in older patients or when bone quality (osteoporosis) will not hold a press-fit securely.

  • Mako hybrid THR

    Cemented stem with an uncemented cup, or vice versa - a middle ground when one side of the joint has better bone than the other.

  • Mako THR for dysplasia or deformity

    A 3D plan built from CT for shallow, dysplastic or previously operated sockets - where cup position is hardest to judge by eye alone.

  • Conventional (non-robotic) THR

    A well-done manual THR remains an excellent operation - for a straightforward hip in experienced hands, outcomes are comparable.

  • Anterior approach Mako THR

    A muscle-sparing anterior approach combined with robotic guidance - offered by a subset of Mako surgeons.

  • Revision THR (selected cases)

    Some revision cases with acetabular bone loss or malpositioned components benefit from robotic planning - case-by-case decision.

  • Consultation only

Other robotic platforms exist - ROSA Hip (Zimmer Biomet) and Cori Hip (Smith + Nephew) are emerging in the UK - but Mako has the longest UK track record and the largest evidence base for hip work.

Safety and complications

What to expect - honestly.

Total hip replacement is one of the most successful operations in modern medicine - but it is major surgery. These are the complications worth knowing about, whether the operation is robotic or conventional.

  • Dislocation 1–3%

    The commonest early complication, driven mainly by cup mal-positioning. Mako’s stated advantage is placing the cup within 3° of plan in >95% of cases - potentially fewer dislocations, though long-term registry data are still maturing.

  • Infection 1–2%

    Deep prosthetic joint infection is uncommon but serious. Reduced with skin-prep bundles, laminar-flow theatres, IV antibiotics and screening. Same-day A&E for a hot, red, swollen hip after surgery.

  • VTE (DVT and PE) - routinely prevented

    Blood clots in the leg or lung. LMWH (or an oral agent), TED stockings, mechanical calf pumps and early mobilisation are standard prophylaxis.

  • Periprosthetic fracture

    A crack in the bone around the implant - 1% at surgery, up to 2–3% over the lifetime of the implant, higher in osteoporosis. May need fixation.

  • Leg length discrepancy - reduced with Mako

    A small leg length difference (up to 1 cm) is common after conventional THR. Real-time intraoperative measurement with Mako makes clinically noticeable LLD less likely.

  • Aseptic loosening and wear

    The reason hip replacements eventually wear out. Highly cross-linked polyethylene and ceramic bearings have extended implant life to 20+ years for many patients.

  • Nerve injury - rare

    Sciatic or femoral nerve injury occurs in under 1% of primary THR. Usually a temporary neuropraxia; permanent injury is very rare.

  • Extra CT radiation (~2–4 mSv)

    Mako requires a pre-op planning CT the conventional route does not - roughly a year of UK background radiation. Small, and outweighed by the planning benefit for most patients.

  • Red flags after surgery

    A sudden clunk with severe pain (possible dislocation), calf swelling and chest pain (possible PE), a hot swollen wound with fever (possible infection) - call the surgeon or A&E the same day.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever approach was used, the note the hip surgeon sends you keeps to the same shape - with the Mako plan-vs-achieved figures added.

A UK consultant hip surgeon reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note before your review, just ask.

  1. 01 Header

    Indication and side operated

    Which hip was replaced, why (OA, AVN, dysplasia, inflammatory) and any relevant prior surgery or deformity noted on the CT plan.

  2. 02 Technique

    Approach, anaesthetic and Mako plan

    Anterior, lateral or posterior approach; spinal or GA; the planned versus achieved cup inclination and version, stem alignment, leg length and offset - the robot’s core deliverables.

  3. 03 Findings

    Implants used and intraoperative findings

    Manufacturer, size and type of cup, liner, head and stem; bearing surface (ceramic-on-poly, ceramic-on-ceramic); anything unexpected - bone quality, cartilage loss, labral tears.

  4. 04 Impression

    Weight-bearing status, review and physio

    Read this first: full weight-bearing from day 1 in most cases, precautions if any, six-week and twelve-week review dates, and your physio plan.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for total hip replacement is standard with most UK insurers when clinically indicated. Robotic-assistance uplifts vary by insurer and policy - some cover Mako in full, some contribute, some require a top-up.

Frequently asked

Everything we get asked about Mako robotic hip replacement.

Quick answers on accuracy, cost, NHS availability, planning CT and recovery.

  • What is a Mako robotic hip replacement, in plain English?

    A total hip replacement where a CT scan of your pelvis is used to build a 3D plan of the exact cup size, position, stem alignment, leg length and offset. In theatre, a robotic arm (Stryker Mako) haptically guides the surgeon’s tools to that plan - the surgeon still performs the operation, but the robot restricts the reamer and cup to the pre-planned trajectory and depth.

  • Is a Mako hip replacement actually better than a conventional THR?

    For cup placement accuracy, yes - multiple studies show Mako places the cup within 3° of plan in over 95% of cases, versus 30–60% for the manual technique, with more accurate leg length and offset restoration. For clinical outcomes at 2–5 years, patient-reported scores are broadly comparable. A long-term revision-rate advantage is plausible but not yet proven at 10–15 years - National Joint Registry data are still maturing.

  • How much does a private Mako THR cost in the UK?

    Roughly £15,000–£22,000 all-in for a standard uncemented Mako THR, £16,000–£23,000 cemented, and £18,000–£25,000 for complex or dysplastic cases. A conventional (non-robotic) THR at the same hospitals is typically £12,000–£18,000 - so the Mako premium is around £2,000–£5,000.

  • Is Mako available on the NHS?

    Yes, at a growing number of NHS trusts - over 50 UK sites now have the Stryker Mako platform (adoption accelerated from around 2020). Whether you are offered it on the NHS depends on your local trust’s equipment and pathway; ask your GP or NHS surgeon.

  • How is the pre-op planning CT different from a normal CT?

    It is a low-dose CT of the pelvis and both hips using a Mako-specific protocol - typically 2–4 mSv, roughly one year of UK background radiation. The scan is uploaded to Stryker’s planning software, which converts it to a 3D bone model so the surgeon can size and position the implants before you arrive in theatre.

  • Which approach - anterior, lateral or posterior - is best with Mako?

    The Mako platform works with all three. The choice depends on your surgeon’s training and your anatomy: posterior is the most common in the UK, anterior is muscle-sparing and often faster to mobilise, lateral is a middle ground. The robotic guidance is on the implant placement, not the approach.

  • How long is recovery after a Mako THR?

    Most patients stand and take first steps on day 0 or day 1, walk with crutches by day 2–3, are home by day 1–3, drop one crutch by 3–4 weeks, drive at around 6 weeks and are back to most activities by 3 months. High-impact sport is generally not advised. Recovery is similar to conventional THR - the Mako advantage is in accuracy, not speed of healing.

  • When should I see A&E rather than call the clinic?

    A hot, red, swollen wound with fever, a sudden severe clunk in the hip with new pain and inability to weight-bear (possible dislocation), a swollen painful calf with chest pain or breathlessness (possible DVT/PE), or spreading redness up the leg - all warrant same-day A&E, not a clinic message.

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