Technological Innovation in Total Knee Arthroplasty: Navigation, Robotics, and Customization

Total knee arthroplasty (TKA) is the gold standard to treat degenerative knee joint conditions that do not improve with conservative treatment, and it yields excellent clinical and functional outcomes. However, a small proportion of patients report some dissatisfaction with their knees after surgery. Recently, TKA underwent significant technological development with the introduction of new biomechanical concepts and the incorporation of techniques to improve surgical procedures. Moreover, the evolution in implant designs optimized for the individual characteristics of the patients enables better surgical customization. The current article presents the concepts, advantages, and limitations to the development of customized implants, as well as TKA surgical techniques involving automation (robotics) and computer-assisted navigation. Although the medical literature showing promising outcomes with new TKA technologies is extensive, studies with longer follow-up and appropriate methodologies are required to contribute to the demonstration of advantages in knee arthroplasty outcomes.