MAKO versus CORI: how the systems differ

In brief

• MAKO plans from preoperative CT; CORI builds its anatomical model from intraoperative mapping.
• MAKO uses an arm-mounted tool with haptic boundaries; CORI uses a handheld robotic burr whose cutting action is modulated at the plan boundary.
• With both systems, the surgeon assesses the information, approves or changes the plan and controls bone preparation.
• Separate studies of each platform cannot establish that one produces better clinical outcomes than the other.

Scope of this comparison

The comparison covers Mako Total/Partial Knee and CORI robotic knee applications in the configurations documented by the cited sources. MAKO also has a distinct Total Hip application. Smith+Nephew lists RI.HIP NAVIGATION for CORI as software-only; it should not be presented as the same robotic bone-preparation function used for the knee.

Criterion	MAKO	CORI
Anatomical model	Preoperative CT model	Intraoperative surface and landmark map
Main planning point	Before surgery, checked and adjustable in theatre	In theatre after registration
Tool	Surgeon-directed, arm-mounted instrument	Surgeon-directed handheld robotic burr
Software boundary	Haptic constraint on tool movement	Burr exposure and/or speed control near boundary
Tracking	Optical	Passive infrared camera
Documented applications	Separate Total Knee, Partial Knee and Total Hip	Total/partial knee; revision depends on current configuration; hip navigation separately

Data and registration

MAKO uses CT to produce a patient-specific 3D model and preoperative plan. In theatre, landmarks are registered to connect the patient with that model. CT-based does not mean the preoperative plan is immutable: the surgeon evaluates it against actual anatomy and joint balance.

CORI does not require a preoperative CT model for the described knee workflow. The surgeon maps bone surfaces and landmarks intraoperatively, allowing the system to construct a model for navigation and planning. Imageless describes the source of the model; it does not mean there is no camera, mapping or visual information.

The organisational trade-off is real but does not establish outcome quality. CT adds preoperative acquisition and a model in advance; imageless planning moves geometrical data collection into theatre. Both depend on accurate registration and appropriate team checks.

Instrument and boundary control

With MAKO, the surgeon physically directs an instrument connected to the robotic arm. AccuStop is the manufacturer’s term for haptic technology that constrains movement relative to the approved plan. The system does not choose that plan or conduct the operation independently.

CORI uses a compact handheld burr. The FDA record describes computer-assisted navigation and surgical burring in which burr exposure and/or speed are controlled near the software boundary. The surgeon holds and guides the tool while the system limits cutting action according to the plan.

Reducing this to “arm: yes/no” misses the essential interaction. The mechanisms organise the relationship between clinician, tool and digital model differently, yet both require active surgical control.

Planning and evidence

Both platforms can support component planning and assessment of joint balance. MAKO begins with its CT model; CORI follows intraoperative mapping. The surgeon interprets measurements and can alter parameters. Neither system diagnoses the patient or chooses an alignment strategy on its own.

A prospective single-centre MAKO series of 55 patients measured resection deviation from the plan. It informs a technical endpoint, not pain, complications or implant survival. A retrospective propensity-matched CORI study compared 215 robotic with 215 conventional TKAs for perioperative, early complication and patient-reported endpoints; its limitations include retrospective design, two surgeons and short follow-up for some outcomes.

These are not head-to-head MAKO–CORI data. Their percentages cannot be treated as one experiment. The search underpinning this page found no adequate direct primary comparison supporting clinical superiority of either platform.

Conclusion without a winner

MAKO and CORI embody different architectures: a preoperative CT model and haptically constrained arm versus intraoperative mapping and a handheld robotic burr. Real-world selection also depends on the operation, locally available configuration and implants, team training and clinical context. Those factors require professional assessment; this comparison is not a patient recommendation.

This material provides general information about the technology. It does not determine whether surgery is indicated or recommend a particular robotic system. Treatment options and methods depend on the diagnosis, anatomy, overall health, technology availability, and assessment by the surgical team. A robotic system is a surgeon-controlled tool; its technical capabilities alone do not guarantee a clinical outcome.