By the way, our hospital bought one but only because a donor gave them the money. I watched the machine in action and spoke with several users. Most hospitals are broke and in 2013 they will be much poorer as the insurance exchanges start. Our hospital forecasts large losses in 2013 unless the health care bill is altered.
It is a major action to buy a $1MM machine and annual service for it. They could have a stall in sales any quarter and it will not be pretty.
For doing aTHR with the MAKO Rio, it does not require a new machine, just some adapters & a new software program. This will make the lesser skilled surgeon an expert, let's face it, 50% of all doctors finished in the bottom half of their class. I suspect your bro is not all that.