18 More Reasons to Love This Rule Breaker

The reasons to be bullish on MAKO Surgical (NAS: MAKO) keep adding up, and we can now officially add 18 more to the list.

The maker of RIO orthopedic devices has just released selected operating results for its fourth quarter and fiscal 2011, while also giving us a sneak peak of what to expect in the new year. MAKO sold 18 RIO systems in the quarter, 16 of which went to domestic customers. For the full year, 48 RIO systems found new homes, bringing the worldwide commercial installed base to 113.

Growth continues to be the name of the game, with MAKOplasty procedures continuing to soar. MAKOplasty procedures performed in the fourth quarter jumped by 97%, to 2,258, with procedures putting up a 99% rise, to 6,932, for the full year.

Laying the foundation for an entirely new phase of growth, 49 MAKOplasty Total Hip Arthroplasty (THA) applications were sold in the year, of which 37 were sold in the fourth quarter. The new procedure was announced in September, boosting shares since it's a win-win-win for investors, patients, and hospitals alike. It generates an additional revenue source for MAKO, reduces complications associated with conventional hip replacement surgery for patients, and adds another reason for hospitals to buy RIO systems by expanding the care they can provide.

Of its domestic commercial installed base, 44% of systems are now locked and loaded to begin performing MAKOplasty THA procedures.

RIO adoption continues to accelerate, with 2012 expected to move between 56 and 62 systems, higher than the 48 sold in 2011. MAKOplasty procedures tell a similar story, with 11,000 to 13,000 procedures expected to be performed.

I picked up shares in September after we made eyes in August, and there's no other way to put this announcement: This is great progress and definitive confirmation of MAKO's rule-breaking ways. It shares many significant similarities with fellow Foolish favorite Intuitive Surgical (NAS: ISRG) , including Intuitive Surgical co-founder and MAKO director Fred Moll. Intuitive Surgical investors who have enjoyed its ride and are looking for their next medical device growth fix should give MAKO some serious consideration. Although it's not profitable yet, MAKO is trending along the path Intuitive set in its early years, and it has a similar model of selling the machines at low margins while collecting high-margin service and disposable-part sales from operating the machines.

It's no wonder that MAKO is so popular among Fools. Colleagues David Meier and Brian Stoffel have joined the MAKO shareholders club recently. Together, we will be looking for MAKO to disrupt incumbents like Zimmer (NYS: ZMH) and Johnson & Johnson (NYS: JNJ) , among others, whose joint replacement solutions may not be the standard of care in the future. Zimmer still looks to replace the total knee, and J&J's DePuy unit, which makes a competing system, landed in hot water less than two years ago over questionable marketing and a recall for its ASR Hip system's failure rate.

Even though shares popped nicely yesterday, this story is far from over, so don't feel like it's too late. With the stock still sitting roughly 27% below its all-time high reached a few short months ago, there's still plenty of time to buy MAKO.

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At the time thisarticle was published Fool contributorEvan Niuowns shares of MAKO Surgical, but he holds no other position in any company mentioned.Click hereto see his holdings and a short bio.The Motley Fool owns shares of Zimmer Holdings, MAKO Surgical, and Johnson & Johnson.Motley Fool newsletter serviceshave recommended buying shares of Intuitive Surgical, MAKO Surgical, and Johnson & Johnson.Motley Fool newsletter serviceshave recommended creating a diagonal call position in Johnson & Johnson. Try any of our Foolish newsletter servicesfree for 30 days. We Fools may not all hold the same opinions, but we all believe thatconsidering a diverse range of insightsmakes us better investors. The Motley Fool has adisclosure policy.

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