Computer Navigation in Total Joint Arthroplasty: Promising in Hips, More of a Bother in Knees

Computer-assisted navigation has been successfully used in many surgical procedures throughout medicine. During the past 10 years, navigation has been used to improve accuracy and reproducibility of component orientation and limb alignment in total joint arthroplasty. This has theoretical advantages to improve pain and function, while potentially reducing dislocation and revision arthroplasty rates. However, these clinical benefits of navigation arthroplasty have yet to be demonstrated. Additionally, although proper component orientation has been shown to decrease dislocation rates in total hip arthroplasty, precise limb alignment along the mechanical axis after total knee arthroplasty has not shown any definitive significant long-term clinical advantage. Navigated surgeries have many disadvantages, including increased surgical times, increased costs, and intraoperative time. We review the advantages and disadvantages of computer-assisted navigation in total joint arthroplasty.