Robert J. Avino, M.D. — Palm Beach County
Mako Robotic Hip & Knee Replacement
Dr. Avino performs all joint replacement procedures using the Mako robotic-arm system — with over 1,000 robotic-assisted hip and knee replacements completed using this technology.
The Mako system combines CT-based 3D planning with robotic-assisted surgical execution, allowing each procedure to be tailored to the patient’s individual anatomy.
How Mako Robotic Technology Works
The Mako system is an advanced surgical platform designed specifically for joint replacement. It combines preoperative imaging, 3D modeling, and intraoperative robotic guidance into one integrated workflow — while the surgeon maintains full control throughout the entire procedure.
Step 1
CT Scan & 3D Modeling
Before surgery, a CT scan captures detailed images of the joint. The Mako system converts this into a three-dimensional model of the patient’s anatomy — including bone structure, joint surfaces, and existing alignment.
Step 2
Personalized Surgical Plan
Using the 3D model, Dr. Avino plans the specific implant size, position, and alignment for each patient before entering the operating room. This planning accounts for individual bone geometry, joint mechanics, and surgical goals.
Step 3
Robotic-Assisted Execution
During surgery, the Mako robotic arm assists the surgeon in executing the plan with precision — guiding bone preparation and implant placement according to the preoperative parameters. The surgeon maintains full control at all times.
Mako Robotic vs. Traditional Joint Replacement
Traditional joint replacement relies on manual instruments and intraoperative measurements to position implants. Mako robotic technology introduces a fundamentally different approach — one where the procedure is planned in detail before surgery begins, then executed with robotic guidance.
Traditional
Manual instruments, intraoperative measurements
Mako robotic
CT-based 3D plan, robotic-guided execution
Traditional
Standard sizing based on templates
Mako robotic
Individualized sizing based on patient anatomy
Traditional
Alignment checked during surgery
Mako robotic
Alignment planned before surgery, verified during
The Mako system does not replace the surgeon — it provides a level of preoperative planning and intraoperative guidance that is not available with traditional techniques alone.
Mako Procedures Dr. Avino Performs
Dr. Avino is certified in three Mako robotic-assisted procedures. Each uses the same CT-based 3D planning and robotic guidance, applied to the specific requirements of the joint and procedure.
Mako Total Knee Replacement
For advanced knee arthritis affecting multiple compartments of the knee. The Mako system plans implant alignment and joint mechanics based on the patient’s individual knee anatomy.
Mako Total Hip Replacement
For advanced hip arthritis. Combined with the direct anterior surgical approach, Mako hip replacement allows precise cup and stem positioning while preserving surrounding muscles.
Mako Partial Knee Replacement
When arthritis is limited to one compartment of the knee. Mako allows precise resurfacing of only the damaged area while preserving healthy bone and ligaments.
As Seen On
Dr. Avino Featured on CBS 12 News
CBS 12 News featured Dr. Avino and the Mako robotic system at Palm Beach Gardens Medical Center, highlighting how robotic-assisted technology is advancing joint replacement surgery in Palm Beach County.
Why Surgeon Experience with Mako Matters
Robotic technology is a tool — the outcomes depend on the surgeon using it. A surgeon’s experience with the Mako system affects how effectively the technology is applied, from the precision of the preoperative plan to the execution of that plan in the operating room.
Dr. Avino has performed over 1,000 robotic-assisted hip and knee replacements using Mako technology. This high-volume experience means patients benefit from a surgeon who has refined his technique across a wide range of joint anatomies and clinical scenarios.
1,000+ Mako Procedures
One of the highest Mako case volumes in Palm Beach County — experience across total hip, total knee, and partial knee replacements.
Stryker Surgeon Consultant
Serves as a surgeon consultant for Stryker Corporation, the maker of Mako technology, and as faculty instructor for advanced robotic surgical courses.
Triple Mako Certification
Certified in Mako robotic-assisted total hip, total knee, and partial knee replacement — all three available Mako joint replacement procedures.
Patient Story
Barbara’s Mako Total Hip Replacement
Barbara credits Dr. Avino and the Mako Total Hip Replacement with bringing back her enthusiasm for life and returning her to the activities she loves.
Mako Robotic Surgery FAQ
Does the robot perform the surgery?
No. The surgeon performs the surgery and maintains full control at all times. The Mako robotic arm provides guidance and assistance during specific portions of the procedure — particularly bone preparation and implant positioning — but does not operate independently.
What is the CT scan for?
The CT scan creates a three-dimensional model of the patient’s joint. Dr. Avino uses this model to plan the precise implant size, position, and alignment before surgery. The CT scan is typically done one to two weeks before the procedure.
Is Mako robotic surgery available for both hip and knee replacement?
Yes. Dr. Avino is certified in all three Mako robotic joint replacement procedures: total hip replacement, total knee replacement, and partial knee replacement.
Does experience with the Mako system matter?
Yes. The technology enhances a surgeon’s capabilities, but the quality of the surgical plan and execution depend on the surgeon’s experience. Dr. Avino has performed over 1,000 robotic-assisted procedures with the Mako system and serves as a faculty instructor for Stryker’s advanced robotic surgical training courses.
Is robotic surgery covered by insurance?
Most major insurance plans, including Medicare, cover joint replacement surgery. However, some insurance carriers do not cover the robotic-assisted portion of your surgery, as they consider it experimental despite supporting clinical evidence. If your insurance does not cover this portion, you will be responsible for that fee prior to your surgery. Dr. Avino’s team can help verify your specific coverage during the scheduling process.
How do I schedule a consultation?
You can request a consultation online or call (561) 694-7776 and ask for Dr. Avino.
Schedule a Robotic Joint Replacement Consultation
If you’re considering hip or knee replacement and want to learn how Mako robotic technology is used in your procedure, a consultation with Dr. Avino is the next step.