Total knee arthroplasty (TKA) is major surgery and liable to post-operative complications and infection is one of the worst and most feared issues. It represents an actual challenge to the orthopaedic surgeon since it is complicated and lengthy to treat. In navigation-assisted TKA, the bone cuts were extramedullary-guided and mapped via navigation and infrared-based systems as per the manufacturer’s instructions. In case of conventional TKA, the femoral bone cuts (distal and chamber cuts) were directed by an intramedullary system and guiding instruments.

This study was performed to compare the long-term effects of navigated total knee arthroplasty with that of conventional TKA. These methods are not so prevalent and common at present. The long-term survivorship, clinical scores and radiographic outcomes of a matched-pair group of 350 patients (350 knees) treated with navigated (n = 157) or conventional (n = 188) TKA for osteoarthritis were reviews over a period of 11 years.

Mean clinical follow-up was done for ten years. The findings did not reveal any clinically relevant differences with regards to clinical outcome, patient satisfaction or pain between the two groups. The navigated group had coronal leg alignment closer (1.7-3.1°) to the neutral mechanical axis as compared to conventional group (2.6-4.7°). Revision surgery (p = 0.04) was performed in 12 knees (6.4%) of the conventional group and 3 knees (1.9%) of the navigated group. This resulted in an absolute reduction of risk of 4.5% for revision surgery with the help of navigation. The ten-year year Kaplan-Meier survivorship was 98.1% and 92.5% in the navigated and conventional groups.

It can thus be concluded that the navigated TKA enhances the implant survivorship compared with conventional TKA.