Robotic-Assisted Joint Replacements Now at ChristianaCare

ChristianaCare surgeons have performed the first robotic joint replacement procedures in Northern Delaware using Mako robotic-arm technology. The technology supports partial and total knee replacements and total hip replacements.

James Rubano, M.D., MBA, and James Costanzo, M.D., performed these first robotic knee replacements in December.

“The Center for Advanced Joint Replacement at ChristianaCare is known for providing our patients with access to the most leading edge technology,” said Matthew Rubino, M.D., MBA, FACS, chair of the Department of Surgery. “With robotic-assisted joint replacement, we can further personalize the procedure for better outcomes for our patients.” In robotic orthopaedic procedures, CT scans before the surgery inform exactly how much bone should be removed and aid in maximizing the accuracy of the alignment and placement of the implant. During the surgery, the robotic arm performs this plan precisely, so that just enough bone is removed.

The robotic arm provides tactile, visual and auditory feedback to assist the surgeon in achieving the best possible alignment for the individual pieces of the joint replacement, which can enhance stability and mobility. “Current studies have shown robotic-assisted total knee replacement to be more accurate and precise compared to traditional, mechanical surgery,” Rubano said. “Further long-term studies will determine the potential for advantages in clinical outcomes such as revision rates and survivorship of implants.” The American Joint Replacement Registry reports that the use of robotics in total knee replacement has increased more than six-fold in the past six years. The American Association of Hip and Knee Surgeons showed in 2024 that 63% of the surgeons are using robotics when performing total knee replacement.