Mako 4 SmartRobotics by Stryker Corporation: status and timeline

Milestones

No announced next step

First Mako partial knee procedureJun 2006Complete.
One million Mako procedures cumulativeMar 2023Complete.
First Mako Spine cases in October 2024Oct 2024Complete.
First Mako Shoulder cases at year-end 2024Dec 2024Complete.
Mako 4 unveiled at AAOS 202511 Mar 2025Complete.
Mako Spine full U.S. rolloutJun 2025Complete.

Most important updates

Stryker unveils Mako 4, integrating hip, knee, spine and shoulder on one platform with fourth-generation Q Guidance11 Mar 2025
Stryker completes first Mako Shoulder cases, entering limited releaseDec 2024
Stryker completes first Mako Spine cases, beginning limited U.S. launchOct 2024

Current obstacles

Surgeon workflow disruption in new applicationsSpine and shoulder surgery ergonomics differ from hip/knee; surgeons must relearn positioning and hand coordination, slowing adoption.
Proving value in low-volume specialtiesShoulder is lower volume than knee; justifying cost requires proven outcome improvements.

Physics limits

Rigid bone anatomy is easier to automate than soft tissueHip and knee replacement involves hard bone landmarks that imaging can identify precisely; spine and shoulder involve muscles, nerves and cartilage that shift and deform, requiring more surgeon judgment.
Surgeon still directs the procedureThe robot is an arm extension, not an autonomous decision-maker; the surgeon must still navigate anatomy, interpret imaging and commit to a plan. Real-time replanning is limited.

How it works

3 parts

Pre-operative planning

3D bone model from CT/MRI

Surgeons create a 3D bone model from imaging, plan implant position, set constraint zones.

Real-time guidance

AI-assisted arm position

Q Guidance confirms arm position against the plan, detects patient motion, adjusts for bone removal.

Safety boundaries

Hard stops and soft zones

The arm enforces no-go zones (e.g., around blood vessels in hip surgery) with hard mechanical stops, and warns the surgeon when entering constraint areas.

Spec sheet

Spec	Mako 4 SmartRobotics
Surgical applications	Hip, knee, spine, shoulder, hip revision^R (reported)
Cumulative procedures performed	Over 1,000,000^R (reported)
Generation	4th (Mako 4)^R (reported)

^R reported by the company

Update log

3 updates

About Stryker Corporation

The team behind Mako 4 SmartRobotics

Stryker Corporation

Mako orthopedic surgical robot, joint replacement

Stryker designs surgical robotics and orthopedic implants. Mako SmartRobotics is the leading orthopedic robot for hip, knee, spine and shoulder replacement. 51,000 employees; NYSE: SYK.

Mako has performed over 1 million joint replacement procedures since 2006 and is the market leader.
Mako 4 consolidates hip, knee, spine and shoulder on one platform with Q Guidance.
Spine and Shoulder launched late 2024; expanding to full U.S. availability through 2025.

stryker.com (opens stryker.com)Company profile →

Founded: 194185 yrs
Headquarters: United States
Status: Public
Listed: SYK (opens google.com)NYSE
Valuation: $117Bmarket capJun 2026
Staff: ~51,000Jan 2026
Works in: RoboticsSurgical & medical
Coverage: 1 program · 3 updateslatest 11 Mar 2025checked 10 Oct
Partners: Intuitive Surgical (opens intuitive.com)
People: Kevin Lobo (opens stryker.com)President and CEO

Spec

Mako 4 SmartRobotics

Surgical applications

Hip, knee, spine, shoulder, hip revision^R (reported)

Cumulative procedures performed

Over 1,000,000^R (reported)

Generation

4th (Mako 4)^R (reported)

Mako 4 SmartRobotics

Milestones

Most important updates

Current obstacles

Physics limits

How it works

3D bone model from CT/MRI

AI-assisted arm position

Hard stops and soft zones

Spec sheet

Update log

Tue 11 Mar 2025

Dec 2024

Oct 2024

About Stryker Corporation

Current obstacles

Physics limits

How it works

3D bone model from CT/MRI

AI-assisted arm position

Hard stops and soft zones

Spec sheet

Update log

Tue 11 Mar 2025

Dec 2024

Oct 2024

About Stryker Corporation