Introduction: Limbmalalignment, component positioning, and proper ligament balance can influence survival of totalknee arthroplasty (TKA) (1,2,3). Significant errors in mechanical axis alignment of greater than 3 percent are estimated to occur in at least 10 percent of total knee arthoplasties, even those performed by experienced surgeons (4). Intra-operative navigation using computer-assisted surgery (CAS) has recently been advocated as a means to improve limb and prosthesis alignment and to assist in ligament balancing in TKA. With recent attention to computer navigation techniques in TKA, we sought to perform a comprehensive review of the published literature to determine whether postoperative alignment outcomes are significantly more accurate and precise with CAS than with non-navigated conventional techniques.
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