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What is a Makoplasty?

Makoplasty is a term created in 2016 by combining the “Mako” Robot name with the term “Arthroplasty”, which is the technical word we use for joint replacement. “Makoplasty” is used to describe a Partial Knee Replacement, Total Knee Replacement, or Total Hip Replacement performed with the Mako Robotic Joint Replacement System.

Mako Robotic Knee Replacement System and implants

Knee Consultation

Partial and Total Knee Replacement Xrays

Dr. Buechel reviewing post-operative x-rays of his knee replacement patient.

Dr. Buechel’s Makoplasty Experience:

Dr. Buechel is an expert user of the Mako™ Robotic Knee system and has an international surgical experience of over 1,500 Mako™ Robotic Partial knee procedures operating on people from around the world. Dr. Buechel understands which patients are best suited for Partial Knee replacement and which patients’ knee arthritis is too advanced and will benefit from Mako™ Total Knee replacement.

Certificate of attendance issued to Frederick F. Buechel, Jr. MD - Mako Total Knee Certification Surgical Training Program April 27, 2017
Certificate of Training issued to Frederick F. Buechel, Jr. MD - has completed the Robotic Arm Interactive Orthopedic System (RIO) Clinical Training Program
Makoplasty Hip Clinical Training Program Certificate of Training issued to Frederick F. Buechel Jr. M.D.

The Mako™ Robotic Knee System empowers Dr. Buechel with more precise information about size, alignment and dynamic ligament balance to make better surgical decisions than with conventional tool systems alone. Optimizing ligament balance, implant position and leg alignment using precision software while making precise, safe bone cuts with the robotic arm’s assistance benefits each patient by providing them with a customized installation. This translates to a more precisely placed knee replacement optimized for each individual’s personal characteristics, producing a more comfortably functioning knee with a more “natural feel”.

Dr. Buechel performing robotic knee replacement

The benefits of using the Mako™ Robotic-Arm System when performing robotic knee replacement surgery over conventional manual tool systems have now been well documented in the peer review literature, of which Dr. Buechel has contributed greatly from his clinical experiences. As a world-leading surgeon expert and an educator of surgeons with this technology, Dr. Buechel has seen first-hand, all of the benefits patients have enjoyed for over a decade with his involvement using Mako™ Robotics for joint replacement.

If your knee is painful, and you are considering joint replacement surgery, you should contact Dr. Buechel through the office at 212-308-3089, via email at, or by starting with our initial Free Consultation online, to see if you can benefit from Dr. Buechel’s unparalleled experience and robotic surgical skills.

Makoplasty Partial Knee Replacement procedures are technically advanced surgical joint replacement procedures for patients suffering from osteoarthritis, osteonecrosis, or post-traumatic arthritis of the knee. Mako Partial Knee Replacement removes only damaged surfaces of the knee, leaving the healthy cartilage surfaces, compartments, and ligaments intact to function normally providing a more stable and natural feel. Patients maintain their important ACL and PCL ligaments in the middle of their knee joint that provide the natural front to back stability and rotational movements during activity. Less bone is removed using this system and these implants than traditional partial knee replacement.

  • This knee resurfacing/replacement procedure uses advanced CT based 3D imaging to virtually size and position pre-operatively the intended implants on the computer software.
  • Intra-operative software is used to adjust the implant placement based on ligament tension and implant tracking.
  • The Mako robot’s precision robotic arm assists the surgeon to prepare the bone to receive the implants exactly where they were planned with sub-millimeter precision.
  • Anatomically designed implants from the Restoris MCK (Multi-Compartment Knee System) are then attached to the prepared bone surfaces with bone cement to provide smooth motion at the joint’s surface that was previously worn down causing pain, swelling, loss of motion and debility.
  • The Restoris MCK implants are made of Cobalt-Chrome Alloy, Titanium Alloy and Ultra-High Molecular Weight Polyethylene (UHMPE) Plastic.
Dr. Frederick Buechel with a knee joint model explaining a knee replacement procedure to a patient.

Dr. Buechel’s Makoplasty Partial Knee Replacement Procedure:

ako Partial Knee Replacement preformed by Dr. Frederick Buechel, Jr. MD is less invasive and has a high patient satisfaction rate (98% satisfaction in published study). Dr. Buechel is a specialist is Partial Knee Replacement Makoplasty surgery and has developed a comprehensive process and program over a decade and 1,500+ partial knee procedures to optimize the results for his patients.

  • Dr. Buechel is an expert in Mako software planning, minimal incision surgery, ligament balancing, robotic bone preparation, and cosmetic closures to optimize each partial knee replacement
  • He uses a minimally invasive approach and a mini incision that is 3 inches or less that does not involve the muscle making the recovery much faster, the pain much less and is very cosmetically appealing. (photo: add incision photo of oliver St…. before and after)
  • Dr. Buechel is an expert Mako surgeon and uses all the features of the Mako software to optimize the position, alignment and tracking of each implant.
  • He does not use a tourniquet which is commonly used by surgeons to stop blood flow during knee surgery. Tourniquets can be a source of post operative pain, slower return to full strength, and potentially they can create blood clots. These are reasons Dr. Buechel does not use tourniquets.
  • Dr. Buechel uses meticulous cement skill to ensure your parts are optimally secured and fixed to your bone surfaces.
  • During the closure of the incision, Dr. Buechel uses advanced suture material designed to hold the tissues together stronger while providing an antibacterial coating to reduce your risk of infection. The skin is sealed using a medical grade skin adhesive glue that also reduces the risk of infection an allows you to shower the day after surgery.
  • Dr. Buechel has developed a rehabilitation program that provides you and your therapist the optimal tools to reduce your swelling, limit your pain, and improve your function rapidly and without significant discomfort.

All of Dr. Buechel’s Partial Knee replacements are performed as an outpatient in New York City at the famous Lenox Hill Hospital or Midtown Surgery Center in the U.S.A. In Asia, Dr. Buechel operates at Taipei Postal Hospital in Taiwan.

Patients' knees after Mako Robotic knee replacement surgery

When is “Makoplasty”, Mako Partial Knee Replacement performed?

A Mako Partial Knee Replacement is typically performed to address painful early, mid and late stage knee osteoarthritis or osteonecrosis in one or two of the three compartments in your knee, when nonsurgical treatments and minor surgical procedures have not been effective, or are no longer effective. This procedure may be right for you if you have persistent knee pain, swelling, or stiffness that makes it difficult for you to do everyday tasks like walking or climbing stairs.

A thorough review of your knee history is completed prior to your procedure. This includes your knee symptoms, duration of symptoms, non-surgical and surgical treatments you’ve had in the past. A review of your medical history is obtained to ensure any medical conditions are managed properly leading up to, during and after your procedure, to optimize your safety and outcome.

Location of Pain for Knee Replacements

Physical Exam
A physical examination of the knee joint is performed in the office prior to final confirmation of your procedure. This will evaluate your leg alignment, knee range of motion, knee joint stability, your vascular system, your strength, your skin, and your joints above and below the knee.

Specific X-rays are reviewed of your knee and legs to evaluate the amount of damage and wear in the compartments of the knee joint, your alignment of your leg and any other issues that might anatomically affect your procedure.

In most cases looking at the history, physical exam and x-rays Dr. Buechel can determine if you’re a candidate for a Mako Partial Knee Replacement. If there are still concerns not fully addressed with these steps, an MRI can be useful in some cases to help make the proper determination whether a partial knee is appropriate, or whether a total knee replacement may be necessary.

X-rays of a knee joint with indication for Medial Partial Knee Replacement
Indication for Medial Partial Knee Replacement
X-rays of a knee joint with indication for Lateral Partial Knee Replacement
Indication for Lateral Partial Knee Replacement
X-rays of a knee joint with indication for Patellofemoral Partial Knee Replacement
Indication for Patellofemoral Partial Knee Replacement
Dr. Buechel performing physical exam

Recovery after Makoplasty

With Dr. Buechel’s minimally invasive Mako Partial Knee Replacement procedure, recovery time tends to be significantly shortened in comparison to other surgeries, and the same procedure by other surgeons. Recovery after Dr. Buechel’s Mako Partial Knee Replacement procedure is usually quite fast, and patients are very functional with minimal discomfort usually by just 3 weeks. Our patients do not stay over night in the hospital. After the anesthesia wears off, you are walking full weight bearing out of the hospital or surgical center, and you are walking in our office the day after surgery.

Usually all walking aids (canes, crutches, walkers) are discontinued within a few days to a week for most patients. Walking is encouraged from day one and a variety of exercises are begun the day of surgery at home, to get you started on your recovery. Formal physical therapy is recommended for most, and we begin that process usually one week after surgery to allow the early swelling to subside, and most of the initial discomfort to go away.

In contrast, following total knee replacement surgery, it often takes around six to twelve weeks before returning to near ordinary daily activities without significant discomfort. Total Knee Replacement is a great option for patients who’s knee deterioration is beyond the scope of a partial knee replacement fix.

Written by: Dr. Frederick Buechel, Jr.

Dr. Buechel is a Stryker certified international instructor and an expert in the field of Robotic-Arm Assisted Knee & Hip Replacement.

Dr. Buechel performs Outpatient Robotic Partial Knee replacement surgery, and Outpatient or short stay Robotic Total Knee replacement in New York City at Lenox Hill Hospital, Midtown Surgery Center and New York Center for Ambulatory Surgery in Manhattan. Dr. Buechel operates at St. Barnabas Medical Center Hospital in Livingston, New Jersey. Internationally Dr. Buechel performs Robotic Knee and Hip replacement in Taipei, Taiwan at Taipei Postal Hospital.

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