Robotic surgery remains a topic of high interest in medtech. The first surgical robot to gain notoriety, the da Vinci, was designed for urogynecological procedures and has enjoyed rapid adoption since its release, despite the fact that its clinical merits remain debatable. Since then, companies have worked to apply robotic surgery to other applications, such as orthopedics and most recently, percutaneous coronary interventions

In orthopedics, MAKO Surgical was the first company to make real headway in this space, initially enjoying rapid uptake of its robotic systems for use in unicondylar knee replacements (the procedure was dubbed ?MAKOplasty?). For awhile, MAKO Surgical was looking like the star of the orthopedics world.
In 2012 though, this company struggled mightily. MAKO's system, the RIO Robotic Arm Interactive Orthopedic System, is very expensive, and therefore only achieved notable adoption among larger facilities able to absorb the expense?this has become a particular concern with the health care reform currently in the works. Additionally, MAKO's system can only be used with the company's own RESTORIS implant, which has a higher selling price than many other implants currently available. And maybe most significantly, the cost savings that MAKOplasty was supposed to offer have yet to be realized. Overall, MAKO Surgical's shares dropped from about $40 at the beginning of 2012 to about $11 today.
The robotic surgical system market in orthopedics might not have reached its peak just yet though. Just recently, Blue Belt Technologies announced its first sale of the NavioPFS system for unicondylar knee replacements. The NavioPFS offers two key advantages over the RIO system. First, it is significantly less expensive, coming in at about $300,000 to $350,000 compared to about $850,000 for the RIO system. Second, the NavioPFS is open-sourced, allowing surgeons to use whichever implant brand they prefer.
So now, the industry is looking to Blue Belt Technologies to drive growth in this space. MAKO does have a head start and offers a primary total hip arthroplasty system as well, but that likely won?t be enough to hold back Blue Belt Technologies.
It looks like MAKO Surgical will be in for another rough year in 2013.

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