Perioperative management of unicompartmental knee arthroplasty using the MAKO robotic arm system (MAKOplasty)

Unicompartmental knee arthroplasty (UKA) is a popular treatment for unicompartmental knee arthritis. Indications for UKA include mechanical axis of less than 10 degrees varus and less than 5 degrees valgus, intact anterior cruciate ligament (ACL), and absence of femorotibial subluxation. Appropriately selected patients can expect UKA to last at least 10 years. UKA failures are not common and involve technical errors that are thought to be corrected with use of newly developed robotic technology. The surgeon using this technology may be able to arrive at a set target, enhance surgical precision, and avoid outliers. Whether improved precision will result in improved long-term clinical outcome remains a subject of research. In this article, we describe the perioperative management of patients who undergo UKA whether with conventional techniques or robotic arm assistance. We also describe the distinct aspects of preoperative, intraoperative, and postoperative pain management and of intraoperative anesthesia and blood management.