When a new technology appears in orthopedics, the first thing that interests surgeons is not glossy presentations, but real surgeries. Who performed them? Under what conditions? With which patients? And what conclusions can be drawn from the facts rather than words?
In the case of MAKO SmartRobotics™ for the shoulder, the first clinical operations took place in 2024–2025, with Australia and the USA playing a key role. This is not surprising: these countries have traditionally been the first to implement robotic orthopedic systems.
Why Australia and the USA
Looking at the history of MAKO, the development is quite logical.
The platform was first introduced for knee and hip arthroplasty, experience was gained, trained teams were established, and only then did indications expand.
Australia is often used as a site for first clinical implementations. There is a well-established system for specialist training, and surgeons actively participate in testing new technologies. The USA, in turn, is a key market for Stryker and a center for major orthopedic research.
(The technical steps of the procedure are detailed in the article: “How the MAKO Robot Works in Shoulder Replacement: Step by Step.”)
First Clinical Experience: Australia
A widely discussed example was a surgery performed in 2025 in Australia on a patient with severe shoulder osteoarthritis and glenoid deformity. Clinically, this was not an “ideal training case,” but the type of patient where precision is critical.
Preoperative CT planning allowed the surgeon to assess the glenoid orientation and select the optimal component placement. During surgery, a robotic arm with haptic feedback was used, preventing excessive bone resection.
According to the clinic:
the glenoid component was placed according to the planned parameters;
the surgery was completed without intraoperative complications;
the early postoperative period was uneventful.
It is important to understand: this is not a “miracle result,” but confirmation that the technology works under real clinical conditions.
Experience in the USA and Professional Conference Data
In the USA, the first series of MAKO Shoulder surgeries were presented at professional orthopedic events, including the American Academy of Orthopaedic Surgeons (AAOS) meetings. Reports focused primarily on the accuracy of glenoid component placement and the match between the actual outcome and the preoperative plan.
Key points emphasized:
high reproducibility of results;
no increase in complication rates;
comparable operation duration after the team completed the learning phase.
For practicing surgeons, this is important. A new technology should not complicate the surgery—it should make it more controlled.
What These First Surgeries Provide in Practice
From a clinical standpoint, the first MAKO Shoulder surgeries are important not in themselves, but because they show the direction of technological development. Robotic assistance stops being theoretical and begins to be applied in real, sometimes complex cases.
For the surgeon, this means:
an additional control tool in complex anatomy;
reduced dependence on subjective factors;
ability to standardize key surgical steps.
For the patient, this means more predictable outcomes and clearer expectations.
(An analytical discussion of the benefits of accuracy and its impact on recovery is provided in the article: “Advantages of Robotic Shoulder Arthroplasty: Accuracy, Recovery, Prognosis.”)
Implications for Further Implementation
The emergence of the first successful operations in Australia and the USA essentially marks the start of the technology’s clinical journey. Typically, this is followed by:
expansion of the number of centers;
accumulation of clinical series;
adaptation of the technology for different patient types.
This process takes time, but it is already underway.
The experience in Australia and the USA shows that MAKO Shoulder goes beyond an experimental concept and is gradually becoming part of clinical practice. The first surgeries confirm the safety, accuracy, and reproducibility of the technology.
Like any new system, MAKO Shoulder requires training and thoughtful application. However, it is precisely these first clinical steps that shape the future of robotic shoulder arthroplasty.
