New and evolving technologies for knee arthroplasty—computer navigation and robotics: state of the art

Computer-assisted navigation was introduced as an adjunct to total knee arthroplasty (TKA) with the potential of improving positioning and alignment of TKA implants. Computer-assisted surgery (CAS) can be divided into: passive (navigated TKA) or semiactive and active (robotic TKA). Passive CAS has shown improved results regarding alignment in TKA compared with conventional instrumentation but it has several possible complications such as registration errors, pin site complications, increased surgical time and a potentially longer learning curve. Robotic TKA has been developed to eliminate the possible error in the preparation of bone surfaces by the surgeon. There is still little evidence on these systems but the early results are encouraging. Despite better results in accuracy with both CAS systems, clinical benefits are still subject of debate. Additional research is required to fully define the costs and benefits of robotics in regular medical practice.