Dr Tarandeep Singh Gill — MS Ortho, MCh Ortho
Director – Joint Replacement & Robotic Surgery · RoboLens FT3D Pioneer · Max Super Speciality Hospital, Mohali
Patients who do their homework before a robotic knee consultation often arrive with one specific question: MAKO or RoboLens? Both are robotic. Both are marketed with similar language about precision and outcomes. But they work differently — and the difference matters enough to understand before you decide.
How MAKO Works
MAKO (Stryker’s robotic arm system) requires a CT scan before surgery. That scan builds a 3D virtual model of your joint, which the surgeon uses to plan the implant position and the bone cuts. On the day of surgery, the MAKO robotic arm physically restricts the cutting instrument to stay within the pre-planned boundaries. If the surgeon moves outside those boundaries, the arm stops.
The advantage: the robotic arm provides physical constraint, which is highly accurate within its planned range. The limitation: the plan is built from a CT scan taken days or weeks before surgery. Your joint on the operating table may not be identical to your joint in the scanner — swelling, positioning, and the load-bearing differences between lying and standing all contribute. The robot executes the pre-built plan precisely; it doesn’t adapt if the plan turns out to be slightly off.
How RoboLens FT3D Works
RoboLens FT3D uses intraoperative imaging — no CT scan before surgery. As Dr Gill operates, the system maps the knee’s actual geometry in real-time using fluoroscopic tracking. The surgical plan is built during the procedure, with data from the joint as it actually is at that moment. If the anatomy looks different from what was expected, the system adapts.
This live planning approach is particularly valuable in deformed knees, where the degree of correction needed is often underestimated by pre-operative imaging. A pre-built CT-based plan for a bow-legged knee might plan for 5 degrees of correction; when the surgeon opens and sees the actual deformity, it might need 7. MAKO executes the original plan. FT3D plans from what it finds.
The No-CT-Scan Difference
This isn’t just a convenience point. CT scans deliver meaningful radiation doses — the knee protocol delivers around 1–3 mSv, roughly equivalent to 6–15 months of background radiation. For younger patients who may need both knees done, this adds up. FT3D eliminates this step entirely.
The pre-operative workup is also simpler. No CT appointment to schedule, no waiting for a 3D model to be processed, no planning session at the hospital before the actual surgery. Consultation to surgery timeline is shorter, which matters for patients in pain who have been waiting long enough.
What the Outcomes Data Says
Both systems produce better alignment outcomes than conventional surgery. The published data on MAKO shows consistent improvement over non-robotic technique in alignment accuracy and patient-reported outcomes. FT3D data from Dr Gill’s practice shows comparable alignment accuracy with the additional benefit of no pre-operative CT and real-time adaptability.
There’s no large head-to-head randomised trial comparing RoboLens FT3D directly with MAKO — that would require hundreds of patients across multiple centres. What exists is the mechanism argument (real-time data is more current than pre-operative data) and the clinical outcomes from centres using each system. Neither system has poor outcomes. The question is which is better matched to your specific anatomy and your surgeon’s training.
Dr TS Gill is trained specifically in RoboLens FT3D and has performed this procedure exclusively for his robotic cases at Max Hospital Mohali. That experience depth with a single system matters — technique refinement with 500+ cases of one system beats divided experience across two. If you’re a candidate for robotic knee surgery and are choosing between systems, book a consultation at tsgillortho.com/appointment to discuss what Dr Gill recommends based on your specific imaging.
