Future?


oh oh, based on misleading etc., looks like Mako will have to stop running their 'town hall' meetings at the seniors homes where they tell the people that they have the answer for knee pain!!!

Is mako the only med device company that displays at AARP's national convention? How many people in the AARP demographic fall under the indication for a uni??
 


Arch Orthop Trauma Surg. 2011 Oct 8. [Epub ahead of print]
Navigation in minimally invasive unicompartmental knee arthroplasty has no advantage in comparison to a conventional minimally invasive implantation.
Weber P, Utzschneider S, Sadoghi P, Pietschmann MF, Ficklscherer A, Jansson V, Müller PE.
SourceDepartment of Orthopaedic Surgery, University Hospital of Munich, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany.

Abstract
INTRODUCTION: Minimally invasive implantation of unicompartmental knee prostheses can shorten rehabilitation time and lead to better functional results than conventional implantation. Exact positioning of the implant should be achieved, as this is a factor for the long-term survival of the prosthesis, although malpositioning can result due to the poor intraoperative view when using the minimally invasive approach. Navigation of the unicompartmental prosthesis could lead to a better implant positioning without losing the advantages of a minimally invasive approach.

MATERIALS AND METHODS: The same unicondylar knee prosthesis was implanted in a total of 40 patients, of whom 20 were implanted using navigation (kinematic navigation) and 20 using a conventional technique. The operating time was assessed in both groups. The orientation of the tibial and femoral implants was assessed radiologically postoperatively. We analysed these results according to the optimal positioning range proposed by the manufacturer. Furthermore, we examined the clinical results with the knee society score (KSS).

RESULTS: A good positioning of the prosthesis was observed in both techniques with only 11% of the radiologic measurements out of the proposed optimal range in each group. The operating time was significantly longer in the navigation group (17 min). The KSS did not differ between both groups at a follow-up of 16 resp. 18 months (navigated group: 184 points, conventional group: 178 points).

CONCLUSIONS: Navigation did not lead to a better positioning of the prosthesis than the conventional method and the operating time was longer. The clinical results were similar in both groups. The navigation may be a useful help for surgeons performing less unicompartmental knee arthroplasty using a minimally invasive approach.
 




I have been looking at Mako after a career in imaging. The word amongst those that I trust is that Mako is a "no go" until the current regime is in place. At a minimum, the VP of Sales and VP of Marketing have to go for it to be a viable organization. Apparently those at the top either cannot recognize competence when they see it, or, they refuse to pay the right $$$ to get good people.
 


I have been looking at Mako after a career in imaging. The word amongst those that I trust is that Mako is a "no go" until the current regime is in place. At a minimum, the VP of Sales and VP of Marketing have to go for it to be a viable organization. Apparently those at the top either cannot recognize competence when they see it, or, they refuse to pay the right $$$ to get good people.

True
 






Huge drop in cash in Q3, significant accounts receivable, significant growth in inventory, stock based compensation expense.

Did you hear how defensive Maurice was about the use of 3rd party implants with the hip? As I said before, there is nothing keeping surgeons from using any hip implant they want.

Contractual obligations with installation agreement? Surgeons will use what is best for the patient. I'm sure Mako will make many enemies if they ever took a surgeon to court for not using a mako implant. They seem clueless about how the ortho business works.

Software validation? An angle is an angle. This is not like the knee where bone is sculpted with precision. Either your instrument is at the right angle or it isn't.

Off-label? Take a look at their 510ks. The rio hip is cleared as a navigation device. Nothing in the 510k refers to a specific implant. The Mako guides a reamer and a cup inserter. These are basic instruments that every cup on the market is compatible with.
 


Oh, did anyone else notice how they're calculating the ASP for the hip? $5,000-$5,500... Not including the stem. Isn't that odd given their strong stance against what they call off-label implants?

One analyst asked what the response has been from surgeons about paying $5,000 for a cup. Maurice danced around and did not answer the question. Look up the transcript and see for yourself.
 




Huge drop in cash in Q3, significant accounts receivable, significant growth in inventory, stock based compensation expense.

Did you hear how defensive Maurice was about the use of 3rd party implants with the hip? As I said before, there is nothing keeping surgeons from using any hip implant they want.

Contractual obligations with installation agreement? Surgeons will use what is best for the patient. I'm sure Mako will make many enemies if they ever took a surgeon to court for not using a mako implant. They seem clueless about how the ortho business works.

Software validation? An angle is an angle. This is not like the knee where bone is sculpted with precision. Either your instrument is at the right angle or it isn't.

Off-label? Take a look at their 510ks. The rio hip is cleared as a navigation device. Nothing in the 510k refers to a specific implant. The Mako guides a reamer and a cup inserter. These are basic instruments that every cup on the market is compatible with.

This company couldn't care less what the FDA or their 510K says.
 


This company couldn't care less what the FDA or their 510K says.

This is a sinking ship. Mako is not attractive for a potential buyer, and the business model for long term sustained growth is a fantasy. The other big ortho's struggle to get their new metal and plastic technology paid for, let alone their patient matched instrumentation. Mako makes some pretty nifty coat racks soon to be placed in equipment storage next to BrainLab and Intuitive...

The future of healthcare is MD gainsharing based on savings. Technology doesn't matter.
 


This is a sinking ship. Mako is not attractive for a potential buyer, and the business model for long term sustained growth is a fantasy. The other big ortho's struggle to get their new metal and plastic technology paid for, let alone their patient matched instrumentation. Mako makes some pretty nifty coat racks soon to be placed in equipment storage next to BrainLab and Intuitive...

The future of healthcare is MD gainsharing based on savings. Technology doesn't matter.

You sound like a typical 'implant rep.' And you may be a very good one. But implant reps don't understand big capital, how to sell it, or why hospital's buy it. I don't work for Mako, but I do sell big capital, and hospitals are still cutting $1mil PO's not only to me, but to reps all across the country. Granted, the economy is not booming, and things are tough, but certain technologies matter, and will drive changes in the standard of care for certain procedures. Again, I don't work for Mako, but they sold 13 robots in the most recent fiscal quarter. THIRTEEN-at an average price of about $800k+.
Now I don't know if they will succeed or fail in the long run, I don't know much about their implants either. But the idea that technology doesn't matter when I'll bring in $2 million in PO's in the next 4 months is hilarious. Again, it's not easy, but nothing is these days.
 


You sound like a typical 'implant rep.' And you may be a very good one. But implant reps don't understand big capital, how to sell it, or why hospital's buy it. I don't work for Mako, but I do sell big capital, and hospitals are still cutting $1mil PO's not only to me, but to reps all across the country. Granted, the economy is not booming, and things are tough, but certain technologies matter, and will drive changes in the standard of care for certain procedures. Again, I don't work for Mako, but they sold 13 robots in the most recent fiscal quarter. THIRTEEN-at an average price of about $800k+.
Now I don't know if they will succeed or fail in the long run, I don't know much about their implants either. But the idea that technology doesn't matter when I'll bring in $2 million in PO's in the next 4 months is hilarious. Again, it's not easy, but nothing is these days.

Capital sales isn't' the issue, the Mako product is. Hospitals still need to replace beds, scopes, power equipment, etc. They don't need to buy a robot to market the smallest sector in knee replacement that increases OR time per procedure without any improvement in results or reimbursement. There is no value added. The best cases scenario is that MDs use tapers off after a few months. Can you hear me now?
 


Agree with last psoter. Mako know nothing about implants and outcomes. The problem is the US medical system. Mako will not find any customers for these 'robots' outside the US, unless they give them.
Have a look at most of the Mako users in the US. Most of them are 'consultants'. Why do you think their SG@A continue to rise as their sales increase.....
Caveat Emptor !!
 


I have been looking at Mako after a career in imaging. The word amongst those that I trust is that Mako is a "no go" until the current regime is in place. At a minimum, the VP of Sales and VP of Marketing have to go for it to be a viable organization. Apparently those at the top either cannot recognize competence when they see it, or, they refuse to pay the right $$$ to get good people.

your not just whistling dixie
 











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