Computer-navigated versus conventional total knee arthroplasty: no difference in implant survival at 15-year follow-up.

Abstract

The introduction of computer-assisted navigation (CAS) in total knee arthroplasty (TKA) aimed to improve prosthetic alignment and potentially enhance long-term implant survival. However, the actual clinical benefit beyond 10 years remains debated. Retrospective comparative study with up to 15-16 years of follow-up, including patients undergoing TKA using either a conventional (CONV) or computer-navigated (NAV) technique. The primary outcome was implant survival (absence of revision for any cause). Secondary outcomes were functional scores: Knee Society Score (KSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Fifteen-year implant survival was 70.5% (CONV) vs. 73.4% (NAV) (p > 0.05). No statistically significant differences were found in functional outcomes. Mortality unrelated to the prosthesis was high in both groups. At 15 years, the navigated technique did not demonstrate significant advantages over the conventional approach in terms of implant survival or functional outcomes. Larger prospective studies are required to confirm these findings.