Computer-assisted TKA: greater precision, doubtful clinical efficacy: opposes

Despite improved precision of component placement and consistent and accurate restoration of neutral limb alignment, controversy persists regarding the clinical benefits of computer-assisted total knee arthroplasty (TKA). Computer-assisted TKA provides excellent information regarding gap equality and symmetry throughout the knee range of motion and allows precise, quantitative soft tissue release for deformities, especially in knees with severe flexion contractures and severe rigid valgus deformities. Hence accurate restoration of gap balance, joint line, and posterior femoral offset consequently improves functional results. Knee arthritis with complex extra-articular deformities and in situ hardware can be tackled appropriately using computer navigation where conventional techniques may be inadequate. It also allows intra-articular correction for extra-articular deformities due to malunions and facilitates extra-articular correction in cases with severe extra-articular tibial deformities. In obese patients, where the alignment of the limb is difficult to assess, computer navigation improves accuracy and reduces the number of outliers. The ability to quantify the precise amount of bone cuts and soft tissue releases needed to equalize gaps and restore alignment, reduced blood loss, and incidence of systemic emboli improves the safety of the procedure and hastens functional recovery of the patient. Hence, computer-assisted TKA not only provides greater precision, but also greater clinical benefit.