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

INTRODUCTION: 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. MATERIALS AND METHODS: 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). RESULTS: 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. CONCLUSIONS: 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.