Orthopaedics · UK
Mako® robotic-arm assisted knee replacement, by a consultant knee arthroplasty surgeon.
CT-based planning, haptic robotic bone cuts and live soft-tissue balancing - for total and partial knee replacement. A named Mako-experienced consultant, an ERAS recovery pathway, and an honest comparison with conventional TKR before you pay the premium.
Indicative pricing
What a private Mako knee replacement costs in the UK.
Indicative ranges across UK private providers.
In short
£16,000–£22,000, home in one to three nights.
| Procedure | Indicative range | Typical theatre time | Hospital stay |
|---|---|---|---|
| Mako robotic-assisted total knee replacement (TKR) | £16,000–£22,000 | 75–100 min | 1–3 nights |
| Conventional total knee replacement (comparator) | £11,000–£18,000 | 60–90 min | 1–3 nights |
| Mako robotic-assisted medial UKA (partial knee) | £14,000–£19,000 | 60–80 min | 1–2 nights |
| Mako robotic-assisted lateral or patellofemoral UKA | £15,000–£20,000 | 60–90 min | 1–2 nights |
| Bicompartmental (medial + PFJ) - selected cases | £17,000–£22,000 | 80–100 min | 1–3 nights |
| Consultant consultation and Mako planning CT | £350–£700 | 45 min + CT | Same week |
Prices vary by hospital, by which surgeon does the case, by the implant chosen, and by length of stay. The Mako premium over a conventional TKR at the same hospital is typically £3,000–£5,000. At Mako-equipped NHS trusts, the same operation may be available NHS-funded.
The problem
A more accurate cut is not automatically a happier knee.
Around one in four to one in five patients say they are not fully happy with a conventional total knee replacement. The Mako pitch is that a better plan and a more accurate execution should fix that. The registry data mostly agrees, cautiously - and we say where it does not.
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Not sure Mako is worth the premium?
Sometimes it is, sometimes it is not. Big deformity, previous fracture and partial knee cases benefit most. Straightforward TKR: less clearcut.
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Confused by ROSA, CORI and VELYS?
They are Mako’s competitors.
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Want an ERAS pathway, not a hotel stay?
Regional block, TXA, physiotherapy from day 0 and home in one to three nights - modern knee replacement, not a week in bed.
When it helps
When Mako-assisted knee surgery is the right step.
The situations we see most, plus the one red flag that means an emergency rather than a clinic appointment.
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End-stage medial compartment OA
The classic Mako UKA case - bone-on-bone medial disease, intact ACL, and preserved lateral and patellofemoral compartments.
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Tricompartmental knee OA
Osteoarthritis across all three compartments with pain that limits walking, sleep and stairs despite injections and physiotherapy - the classic Mako TKR case.
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Significant varus or valgus deformity
A bowed or knock-kneed alignment where conventional jigs struggle - robotic planning and haptic cuts help hit the intended alignment reliably.
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Post-traumatic knee arthritis
Arthritis after previous fracture or ligament injury, sometimes with retained metalwork or extra-articular deformity that makes conventional jigs unreliable.
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Younger, active TKR candidate
A patient with more life expectancy than the implant - where implant position, alignment and soft-tissue balance really matter for how long the knee lasts.
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Lateral or patellofemoral UKA
Isolated lateral or patellofemoral compartment disease - historically undersupplied, and one of the strongest indications for a Mako-planned partial replacement.
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Previously unhappy contralateral TKR
A patient whose first knee replacement never felt right, considering the second side - where hitting the plan the first time matters more than usual.
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Red flag: hot, red, painful knee
Fever with a hot, swollen knee - especially after any joint injection or previous replacement - is a possible septic arthritis. Same-day A&E, not a clinic booking.
Procedure options
Mako TKR is not the only option.
What each option on the table actually involves - Mako, its competitors, and the non-operative path.
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Mako robotic TKR
Total knee replacement planned on CT and executed with the robotic arm. Haptic control keeps the saw inside the planned resection depth and angle to sub-millimetre tolerances.
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Mako medial UKA (Restoris MCK)
Robotic medial unicompartmental knee - the workhorse partial replacement, with the strongest long-term registry data of any Mako knee application.
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Mako lateral UKA
Robotic partial replacement for isolated lateral compartment disease - technically demanding by hand, and one of the clearest wins for robotic planning.
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Mako patellofemoral joint (PFJ) replacement
Robotic replacement of just the kneecap and trochlea for isolated PFJ arthritis - a niche but well-suited Mako application.
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Mako bicompartmental (medial + PFJ)
Combined medial UKA and PFJ replacement in the right anatomy - investigational, offered in selected units with experienced surgeons.
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Conventional TKR (comparator)
Jig-based total knee replacement without a robot. Cheaper, quicker in theatre, and the option most units still default to when Mako is not needed.
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Other robotic platforms
ROSA (Zimmer Biomet), CORI (Smith & Nephew), VELYS (DePuy Synthes) - emerging competitors with less UK track record than Mako, but similar accuracy claims.
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Non-operative comparator
Weight, load, physiotherapy, oral analgesia and intra-articular injection can buy years - worth exhausting before any replacement, robotic or not.
Safety and recovery
What to expect afterwards - honestly.
Mako improves the accuracy of the cut. The rest - infection, DVT, stiffness, loosening, the “unhappy TKR” problem - are still knee-replacement risks and worth understanding before you choose.
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Accuracy of the cut, not magic
Robotic execution improves bone-cut accuracy to under 1 mm and 1° versus 3–5 mm and 2–3° with conventional jigs. That is real. Whether it changes how your knee feels at ten years is not yet settled.
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Extra CT, small radiation dose
The Mako plan needs a lower-limb CT - roughly 2–4 mSv, similar to a year of natural background radiation. A conventional TKR needs only standard X-rays.
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A little longer in theatre
Setup, tracker pins and registration add roughly 10–20 minutes of operative time compared with a straight jig-based case. This shortens as the team gets more Mako reps.
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The "unhappy TKR" problem
Around 20–30% of conventional TKR patients report they are not truly happy with their new knee. The hope, not yet fully proven, is that better implant position and soft-tissue balance with Mako reduces that number.
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Infection, DVT, stiffness, loosening
Robotic assistance does not change the classic replacement risks: infection 1–2%, VTE despite prophylaxis, stiffness needing manipulation under anaesthesia (MUA), and late aseptic loosening. These are TKR risks, not Mako risks.
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Pin-site issues (rare)
Femoral and tibial tracker pins are a very small extra risk - infection or, exceptionally rarely, a stress fracture at the pin site. Modern smaller pins have made this rarer still.
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Long-term data still maturing
Medial Mako UKA has excellent 10-year registry survivorship in some series. For Mako TKR, a survivorship advantage over conventional at 10–15 years has not yet been proven - the technology is too new.
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ERAS, blocks and early mobilisation
Adductor canal and genicular nerve blocks, spinal or GA, tranexamic acid, LMWH for 14–35 days, physiotherapy from day 0 and discharge on day 1–3 is the modern standard - robotic or not.
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Red flags after discharge
A hot, red, swollen knee, spreading redness, a temperature over 38 °C, sudden severe calf pain, breathlessness or chest pain after surgery are not normal - call the ward or A&E the same day.
Reading your operation note
Your Mako operation note in four parts. Read the last one first.
Whether you had a Mako TKR or a Mako UKA, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Arthroplasty 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.
- 01 Header
Diagnosis, side and implant chosen
Which knee, what type of arthritis, the planned implant (TKR or UKA), the manufacturer and the alignment strategy - mechanical, kinematic or functional.
- 02 Technique
Mako plan and intra-operative execution
The CT-based plan, the registration accuracy, the intra-operative gap balancing figures, and how closely the executed cuts matched the plan. Any manual conversion is noted.
- 03 Findings
Cartilage, ligaments and any surprises
Findings at surgery - cartilage grade in each compartment, ACL condition (crucial for UKA), any osteophyte load and any deviation from the pre-op plan.
- 04 Impression
Recovery plan, precautions and review
Read this first: weight-bearing status, physiotherapy plan, VTE prophylaxis duration, driving and return-to-work timing, and when the surgeon wants to see you back.
Recognised by major UK insurers
Cover for knee replacement is usually funded when medically indicated. The Mako premium may or may not be covered depending on your policy - some insurers reimburse the conventional TKR tariff and leave you to top up the robotic fee.
Frequently asked
Everything we get asked about Mako knee surgery.
Quick answers on evidence, cost, recovery, radiation, and how Mako compares with the newer robotic platforms.
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Is Mako actually better than a conventional knee replacement?
On the bone cut, yes - multiple randomised trials show cutting error under 1 mm and 1° with Mako versus 3–5 mm and 2–3° with conventional jigs, and better implant positioning and soft-tissue balance. At two to five years, functional and clinical outcomes look comparable. A clear ten to fifteen year survivorship advantage over conventional has not yet been proven for TKR. For medial UKA, Mako has excellent long-term registry data.
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What does Mako robotic knee surgery cost privately in the UK?
Roughly £16,000–£22,000 for a Mako TKR and £14,000–£20,000 for a Mako UKA at reputable London units. Conventional TKR is £11,000–£18,000 at the same hospitals - so the Mako premium is typically £3,000–£5,000. Some NHS units at Mako-equipped sites offer it NHS-funded.
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What is the difference between Mako TKR and Mako UKA?
A total knee replacement (TKR) resurfaces all three compartments of the knee. A unicompartmental knee arthroplasty (UKA), or partial replacement, resurfaces only the diseased compartment - usually the medial side - and keeps your own ACL and healthy cartilage. Both can be planned and executed with the Mako robot.
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How is Mako different from ROSA, CORI or VELYS?
They are competing robotic platforms - ROSA from Zimmer Biomet, CORI from Smith & Nephew and VELYS from DePuy Synthes. Mako (Stryker) has the longest UK track record and the most published evidence, particularly for medial UKA. The others are catching up and, in the hands of experienced surgeons, can produce similar accuracy.
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Does the Mako CT scan give me a lot of radiation?
The lower-limb Mako CT is roughly 2–4 millisieverts - about a year of natural background radiation, or a couple of chest CTs. It is a real, small dose that conventional TKR planning does not need - worth mentioning to your surgeon if you have already had many scans.
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How long is recovery after a Mako knee replacement?
The recovery is that of a knee replacement - Mako does not change it dramatically. Hospital stay one to three nights, walking with sticks in the first two weeks, driving at four to six weeks, back to a desk job at four to six weeks and to heavier work by three months. Full comfort keeps improving for a year.
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Is Mako suitable if I have a lot of deformity or previous fractures?
These are actually the strongest cases for robotic planning. Extra-articular deformity, retained metalwork or bowed alignment make conventional jigs unreliable - CT-based Mako planning bypasses the jig and works off your actual bone anatomy. Discuss it with a Mako-experienced surgeon.
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What can go wrong with a Mako knee replacement?
The classic knee replacement risks - infection 1–2%, DVT or PE despite prophylaxis, stiffness needing MUA, patellar problems, late aseptic loosening and residual pain - apply exactly as they do to conventional TKR. Mako-specific extras are the CT dose, slightly longer theatre time and a very small pin-site risk from the tracker pins.
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