Abstract
This study aimed to compare radiographic accuracy, perioperative parameters, and early clinical outcomes between computer-assisted navigation total knee arthroplasty (TKA) and conventional TKA. This retrospective single-center study included adult patients who underwent primary TKA between January 2023 and December 2024. Patients were allocated to either a navigation group or a conventional control group based on the use of a computer-assisted navigation system. All other perioperative management followed a standardized institutional protocol. Demographic characteristics, comorbidities, and preoperative functional status - including Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index - were comparable between groups. Primary outcomes included operative time, intraoperative blood loss, radiographic alignment parameters (hip-knee-ankle angle, femoral and tibial component positioning in coronal, sagittal, and rotational planes), and mechanical axis outliers. Secondary outcomes included early postoperative visual analog scale pain scores, knee range of motion at discharge, length of hospital stay, and complication and reoperation rates. A total of 159 patients were included, comprising 91 in the navigation group and 68 in the control group. Operative time was significantly longer in the navigation group, whereas intraoperative blood loss was significantly lower compared with the control group. Radiographic evaluation demonstrated that navigation TKA achieved more accurate restoration of the hip-knee-ankle angle, reduced mechanical axis outliers, and smaller deviations in femoral and tibial component alignment across coronal, sagittal, and rotational planes. Early postoperative clinical outcomes favored the navigation group, including lower visual analog scale pain scores, greater knee range of motion at discharge, and a modestly shorter hospital stay. Although prosthesis-related complications, medical complications, and reoperation rates were numerically lower in the navigation group, these differences did not reach statistical significance. Computer-assisted navigation TKA improved radiographic alignment accuracy and was associated with favorable early postoperative clinical outcomes compared with conventional TKA, albeit with longer operative time. While complication and reoperation rates were not significantly different, navigation may offer benefits in surgical precision and short-term recovery. Further prospective studies with long-term follow-up are warranted to determine its impact on implant survival and functional outcomes.